The Dental Truth Project

Kevin Cumbus, President and Founder of TUSK Practice Sales, shares what he’s seeing across the dental M&A market—and why practice owners may need to rethink what their business is actually worth. After more than $1.5 billion in dental transactions, Kevin discusses what buyers, lenders, private equity groups, and distressed DSOs are looking for—and explains why simply waiting for interest rates to fall may not bring the old market back. But the biggest disruption may not come from the M&A market at all. Kevin paints a provocative picture of a future where AI, robotics, and new technology could completely change how dental hygiene is delivered—and potentially reshape the value of traditional dental practices. Revelations: The Dental M&A Market Has Changed The Changing Dental M&A Market - The days of $2M EBITDA businesses commanding 10–11x multiples with 70% cash at close may be gone. Buyers are increasingly focused on deal structure—not just the headline multiple. AI, Robotics & the Disruption of Dental…

Matthew Godley, CEO and co-founder of Spendly and the son of a dentist and dental hygienist, exposes the uncomfortable truth about where DSO profits are quietly disappearing: 4 out of 10 vendor invoices contain billing errors, practice owners are overpaying on nearly every operating expense without knowing it, and the leak compounds silently for years - yet almost no one has the time, bandwidth, or expertise to catch it before it costs them at the exit table. Revelations: The Hidden Profit Leak in Your Vendor Bills 4 out of 10 vendor invoices have an error - overcharges, hidden fees, or outdated pricing on essentials like payroll, tech, telecom, and merchant services The top three biggest opportunities: lab fees, tech agreement & invoices, and merchant services ("legal loan sharking" hiding in plain sight) Accrual accounting is your early-warning system - because it recognizes lab costs when the work is delivered (not when it's paid), errors surface as a real-time pulse check instead of hiding until the bill…

Jordan Comstock, founder and CEO of BoomCloud, challenges one of dentistry’s most common revenue models: PPO dependency. He reveals how patient membership programs can create predictable recurring revenue, help practices reach break-even faster, increase treatment acceptance, and give owners a financial safety net before transitioning away from insurance. But there’s a catch—getting the numbers right isn’t enough. Your team has to believe in the strategy, too. Revelations: Are PPOs Holding Your Dental Practice Back? Patient membership programs offer an alternative to dental insurance, with patients paying a monthly or annual subscription in exchange for benefits and savings. Predictable recurring revenue can help practices reach their break-even point faster and reduce the uncertainty of relying on collections from traditional PPO patients. Jordan explains why practices shouldn't necessarily drop PPOs overnight: build the membership program and financial safety net first, then strategically transition away…

Dave Salciccioli, Co-Founder of Relay and a dental technology veteran, pulls back the curtain on one of dentistry’s biggest—and most overlooked—problems: the technology isn’t necessarily the problem. How the industry buys, implements, and adopts it is. Dental organizations have access to better technology than ever before, from AI to emerging SaaS solutions. Yet many DSOs are struggling to turn those tools into real operational results. Failed implementations, overlapping software, ballooning costs, disconnected systems, and exhausted teams are creating an expensive gap between buying technology and actually making it work. Revelations: The Hidden Reason Your Tech Investments Keep Failing The dental industry may have better technology than ever—but lacks the implementation infrastructure to use it effectively. The biggest hidden cost may be something you can't put on a software invoice: your team's goodwill toward change. Before buying something new, have you fully diagnosed what is broken—and whether you're…

Josh McSpadden, Mid Market Healthcare Group Banker at U.S. Bank, reveals why DSOs don’t just need a lender—they need a banking partner who understands the strategy behind their growth. After working with dental groups since 2015, Josh exposes a costly mistake many emerging DSOs make: choosing financing based on the lowest rate instead of building the right financial infrastructure from the beginning. The result? Complicated debt, inefficient cash management, and expensive cleanup when the DSO finally hits its next stage of growth. Revelations: The Banking Mistake That Can Follow Your DSO for Years The cheapest loan isn't always the best financing strategy—your banking structure needs to support your growth plan. DSOs can avoid costly debt "cleanup" by bringing the right banking partner into the strategy early. A strong banking platform can help with more than lending—including treasury management, fraud prevention, associate ownership, and real estate. As DSOs grow, financial responsibilities should move…

Ken Kaufman and Ashley Penny pull back the curtain on the creation of their second book, Roll The Equity: How Smart Dental Founders Sell Their DSOs, revealing what inspired them to write it and how they worked together to turn complex dental finance and private equity concepts into an engaging story. Their collaboration builds on the success of their first book while taking readers deeper into the decisions dental leaders face when growing, selling, or partnering with private equity. Revelations: How Roll the Equity Came to Life Why the success of their first book inspired Ken and Ashley to tackle the next financial challenge facing growing dental organizations. Why Roll the Equity goes beyond financial tools to explore private equity, acquisitions, mergers, recapitalizations, and different paths to growth. Why every DSO deal is different—and how different decisions can lead to very different outcomes. How the financial tools from the first book—accrual accounting, annual budgets, and 12-month rolling…

Sam Rockwood, Founder & CEO of Woods and former actuary, exposes the hidden inefficiencies behind insurance payments. With roughly 70% of dental insurance payments still being paper-based, practices are stuck dealing with checks, virtual credit cards, hidden processing fees, and hours of manual work. And the biggest surprise? Free EFT is available—but many practices don't know how to access it. Revelations: The Insurance Payment Trap Most Dental Practices Never Question HIPAA requires insurance companies to offer a free EFT option—but many practices don’t know how to access it and may be directed toward paid alternatives unless they specifically ask for the free option. 70% of insurance payments are still paper-based—even in 2026. Virtual credit cards can cost practices 3–5% per payment through merchant processing fees. Getting paid electronically isn't enough—if EOBs aren't posted correctly, your AR can grow while your financial statements become inaccurate. The real problem isn't just getting off checks.…

Christine Diehl, a dental hygienist with 30+ years of experience, shares the uncomfortable truth about what happens when a dental practice transitions to a DSO—and why the biggest risk may not be the financial deal itself. When teams feel ignored, patients can follow them out the door. When buyers rush to change everything, they can destroy the trust and culture that made the practice successful in the first place. And losing just one hygienist could cost a practice anywhere from $30,000 to $120,000. Christine reveals why the first 90 days after a transition can make or break the future of the practice—and why sometimes the best strategy is to change nothing. Revelations: The People Side of Every DSO Deal Losing a single hygienist during a transition can cost a practice $30,000-$120,000 in lost patients, recruiting, and temp coverage Teams go through an actual grief process post-sale — and most buyers never account for it "In-house" transition teams report to corporate, not to the team — creating a trust gap…

Courtney Staiger, Certified Fraud Examiner at Prosperident, reveals one of dentistry's most overlooked threats: 70% of dental practices will experience embezzlement, yet most owners don't have fraud prevention systems in place because they assume it won't happen to them. The real danger? It's rarely obvious cash theft—it's hidden in reports, refunds, insurance payments, and everyday processes that practice owners often overlook. Revelations: The Truth About Embezzlement Every DSO Leader Needs to Hear 70% of dental practices will experience embezzlement—yet only a handful of DSOs have fraud controls in place. The biggest red flags aren't missing cash—they're employees who control every financial process, refuse oversight, and insist they're the only ones who can do the job. A sudden spike in Accounts Receivable, unexplained refunds, or unusual P&L trends could signal something much bigger than poor collections. Cash, checks, EFTs, and credit cards are all vulnerable—no payment method is immune without proper…

Kevin Henry, a dental journalist for 27 years and Editor-in-chief for DrBicuspid.com, exposes one of dentistry’s biggest missed opportunities: your dental assistants may be capable of far more than you’re letting them do. From staffing shortages and poor training to practices losing great assistants because they see no path forward. Kevin reveals why the problem isn’t always finding better people—it’s learning how to develop, empower, and retain the people already on your team. Revelations: The Untapped Power of Your Dental Assistants One Dentist’s Way Isn’t the Industry Standard: An assistant may be trained to work exactly the way one dentist prefers, but that doesn’t necessarily prepare them to walk into another practice and meet a different dentist’s expectations. Your Assistant Could Be Your Practice’s Biggest Productivity Multiplier: In states with expanded scopes of practice, properly trained assistants can take on more responsibilities and free dentists to focus on higher-value procedures. Give Your…

AccruDent turns two, but this episode isn’t about celebrating the wins alone. For the first time, Ken and Dallin Kaufman take over the podcast to share the real story behind building AccruDent: the original business idea that was far too broad, the painful client failure that changed how they operate, and the realization that ultimately forced them to niche down. From trying to solve every problem inside a DSO to becoming the financial partner for emerging dental groups with 5–20 locations, their journey was anything but linear. Revelations: The failures have been just as important as the successes The original AccruDent business model was so broad that early client engagements could turn into hours of meetings — and ultimately forced them to rethink their entire approach. Saying “yes” to too much led to missed deadlines, under-delivery, and the loss of a client — a failure that became one of their most important business lessons. AccruDent discovered that accrual-based accounting was a major unmet need…

Andy Steuerman, Vice Chairman at Golub Capital, and Dr. Victoria Yu, CEO & Chief Dental Officer of Elite Dental Partners, challenge one of dentistry's biggest assumptions: that dentists must choose between being lifelong employees or taking on crushing debt to become owners. They reveal why the traditional DSO model is broken, why new graduates are trapped by six-figure student loans, and how a disruptive equity model could redefine the future of dental practice ownership. Along the way, they unpack why the best-performing practices don't just focus on dentistry—they build leaders, entrepreneurs, and healthier communities. Key Revelations: The DSO Model Is Due for a Reset The employer-employee model is failing dentists—and partnership may be the future. Ownership doesn't have to require massive debt or buying your own practice. High-performing practices are built when clinicians think like entrepreneurs, not employees. Leadership, financial literacy, and communication are the missing skills holding practices…

Adrian Lefler, CEO of My Social Practice, reveals why most dental organizations are already falling behind, and they don't even know it. AI isn't just changing marketing tactics; it's completely rewriting how marketing teams should be built. While many DSOs are still hiring yesterday's roles, the companies winning tomorrow are replacing repetitive work with AI automations and creating entirely new positions that didn't exist six months ago. If your marketing department still looks the same as it did a year ago, this conversation may explain why your growth is slowing while others are accelerating. Key Revelations: The Double Blind Killing DSO Marketing Teams AI has fundamentally changed dental marketing in the last six months, and most organizations haven't adjusted their team structure. Executives face a dangerous "double blind" problem: leaders don't know what's possible with AI, while marketing teams don't know what skills they're missing. Many marketing teams are spending months learning AI tools when…

Angie Hopper, Chief Operating Officer of Premier Dental Center, breaks the industry's favorite rule: go fee-for-service or lose out. While the loudest voices in dentistry preach dropping insurance to protect margins, Premier Dental Center did the opposite — went deeper in-network — and grew one location from 4 operatories to 12, added a 10-op and a 6-op site, and now runs on 80% insured patients. The catch: smaller margins mean zero room for sloppy operations. This episode challenges one of dentistry's biggest assumptions: You don't have to choose between serving more patients and building a profitable practice. With the right systems, operational discipline, and financial strategy, you can do both. Key Revelations: Growing Bigger by Taking Less Per Patient Why choosing to serve more patients instead of maximizing profit per patient created a stronger culture, accelerated growth, and built a more resilient dental organization. How negotiating directly with insurance companies, manufacturers, and financing…

Dr. Vinni Singh, founder of DentScribe and practicing dentist reveals why many dental practices are chasing the wrong growth strategy. While owners pour money into attracting new patients, they're overlooking the biggest revenue opportunity already sitting in their chairs. She explains how overlooked clinical notes, forgotten patient conversations, and inefficient workflows quietly cost practices thousands in production every year—and how AI is helping dentists deliver better care while increasing case acceptance without adding more staff. Key Revelations: The Money You're Forgetting You Already Made AI-powered clinical notes do more than document visits—they build a psychological buying profile that helps your team present treatment in the way each patient is most likely to accept. The biggest revenue opportunity isn't attracting more new patients—it's identifying the treatment opportunities already hidden within your existing patient base. Smart documentation becomes a coaching tool, helping new dentists…

Frank Clayton, CEO & Founder of RedThread Solutions, Former Practice Owner and PE Advisor — de novo practice founder turned DSO insider — spent 23 years building a high-performing practice, sold to a DSO, and then watched the machine from the inside during a two-year earnout. What he saw confirms what many DSO operators quietly suspect: the people problem is the real operational crisis, and most PE groups are managing spreadsheets while their best employees quietly walk out the door. Post-acquisition, the moment a key employee leaves, they take with them 15 years of patient relationships, clinical knowledge, and the invisible systems that no SOP manual can capture — and DSOs are losing hundreds of thousands of dollars before they even see the smoke. Key Revelations: The Hidden Cost of Losing Your Key People A single key employee exit can cost a practice six figures in lost production, recruiting, and ramp-up time — before you factor in patient attrition Dental practices aren't plug-and-play factories;…

George Hariri, Chief Financial Officer and Co-Founder of Shared Practices, exposes why most multi-location dental groups are quietly bleeding value: the "economies of scale" pitch is a fallacy once you factor in higher debt costs and bloated central teams, centralizing functions just moves expenses around instead of cutting them, and the GP acquisition model has an identity crisis — everyone's buying the same eight-op, $2M+ practice with no real plan to add value once they own it. Key Revelations: Why Bigger Isn't Always Better Multi-location debt is more expensive — DSOs pay higher interest and carry a full executive layer on top of practice-level costs "Maturation means centralization" is a trap — pushing work to a central team doesn't eliminate practice-level costs, it just duplicates them Most General Practice acquisition groups buy the exact same practice profile, which means they all give private equity the exact same answer to "what makes you different?" The old playbook — buy low, sell high, change…

Most dental leaders only share their wins. Dr. Hardik Chodavadia, Co-Founder of Enamel Dentistry, does the opposite — and that's exactly what makes this episode required listening. A highly capable, deeply trusted team member stole a significant amount of money from Enamel Dentistry — and the worst part? They saw the warning signs and couldn't act because he was too embedded to remove. From a trusted team member who stole from the business to the AI technology quietly transforming how his teams perform, Dr. Hardik gives you the unfiltered version of what building a DSO really looks like. Key Revelations: When "Indispensable" Becomes a Liability Embezzlement in dental is far more common than anyone admits. Most operators only hear about it after it happens to them Never let one person hold the keys to everything — access, relationships, systems, and finances should never all live in the same hands If removing someone feels impossible, that's the signal — not a reason to wait, but a reason to restructure now…

Secure Dental CEO and working clinician Dr. Nazish Jafri has sat across from enough new graduates to see the pattern clearly: the clinical skills aren't the problem. It's everything nobody taught them — how to talk to a patient, how to read a treatment plan, how to understand what they actually need to earn just to survive. They're not failing because they're incapable. They're failing because no one ever had their back. Hundreds of new dentists graduate every few weeks — armed with textbook knowledge, mannequin experience, and a social media feed full of full-arch implant cases and veneer galleries. They walk into their first job expecting Day 1 to look like a highlight reel. Nobody told them it wouldn't. Key Revelations: What Happens When New Dentists Have No One to Call? New grads are being shaped by social media "gurus" — expecting full-arch implant cases and veneer galleries on Day 1 Most can't answer: "What are your monthly expenses?" — yet they're negotiating salaries and signing contracts Dental…

Dave Gaspar, CEO of Smile Partners USA, exposes the hiring blind spot that's quietly killing dental careers: practices have obsessed over clinical skill and chairside personality for decades — but nobody's testing for the one quality that actually predicts whether a dentist survives the hard days. When the CBCT crashes, the assistant calls out sick, and patients are walking out the back door, IQ and EQ won't save you. Dave calls it the Adversity Quotient (AQ) — and he argues that until the industry starts screening for it, recruiting will keep failing doctors, practices, and patients alike. Three scores that predict a dentist's success: IQ — The Clinical Score Can they perform the procedure? Do they have the technical skills? This dominated hiring conversations for decades. EQ — The People Score Can they connect with patients? Can they lead a team? This became the next frontier of great hiring. AQ — The Adversity Quotient Can they handle a bad day? Do they take ownership when things go wrong? This is the…

Mark Haddad, Endodontist and Co-founder of Specialty1 Partners and ScoutIQ, pulls back the curtain on what private equity actually wants — and why most dentists walk into a deal completely unprepared. At the heart of every PE transaction is one defining decision: do you take the cash and walk away, or do you roll your equity and bet on a bigger payday down the road? If you've ever thought about selling your practice or scaling with PE backing, this episode will change how you think about both paths — and help you figure out which one is right for you Option A Cash out Full liquidity at close. Best for founders nearing retirement or those who want a clean exit. You walk away with 100% of the agreed value — no strings, no risk, no upside. Option B Roll the equity Take partial cash now, convert the rest into ownership of the larger DSO. If the group grows, your stake multiplies. Mark calls it "the second bite of the apple" — and it's how younger founders build serious long-term wealth. Key Revelations: What…

Corey Hastings, CEO of Blue Sage Management Group and practicing pediatric dentist, exposes the uncomfortable truth most multi-location dental owners refuse to admit: scaling from one to seven locations almost broke him — not because of bad dentistry, but because he couldn't get out of the chair. The clinical skills that built his practice became the very thing holding it back. Key Revelations: Why Your Greatest Strength Becomes Your Biggest Bottleneck Most dentists don't have a clinical problem — they have a leadership problem they're solving with more dentistry When you're still producing a significant chunk of your revenue and EBITDA, you're permanently stuck between two roles — the producer and the leader — and neither one gets your full attention The hidden cost of staying clinical too long: your team stops making decisions because nobody ever taught them how — and that indecision comes right back to you as decision fatigue Your associates graduated knowing how to fill a Scantron. Nobody taught them how…

Virginia Jones, CEO of Village Family Dental (14 locations, 400 employees) & Gary Salman, CEO of Black Talon Security reveal the silent threat that could shut your practice down — not a bad review, not a slow month, but a cyber event you never saw coming. Post-Change Healthcare breach, dentistry is still 3–4 years behind the rest of healthcare on cybersecurity — and the hackers already know it. Small practices think they're flying under the radar. Large groups think their IT team has it covered. Both are wrong. Key Revelations: The Invisible Threat Inside Your Practice 70% of dental practices treat cybersecurity as a once-a-year checkbox — the hackers treat your network as an everyday opportunity The government doesn't care if you're a 1-chair solo practice or a 50-location DSO — HIPAA fines hit everyone equally, and dentistry has been slow to realize it Dentistry is 3 to 4 years behind the rest of healthcare on cybersecurity. And the hackers already know it. Stop calling it an expense and start calling it…

Randa Seif, COO of CaliDental, issues a stark warning to every dental practice owner scrolling through AI vendor ads: handing over your patient data to the wrong company isn't just a bad business decision — it could be a legal and ethical catastrophe. After personally vetting vendors from Australia, Amsterdam, and across the U.S., she reveals why most AI companies knocking on your door have no business being inside your practice management system. Key Revelations: The Vendor Trust Crisis No One Wants to Say Out Loud Vendors are cold-pitching practices on Facebook and Instagram with $70,000 blank-check proposals — and most have never worked a day inside a dental office If an AI vendor can't prove they understand your workflow, they cannot build something that works for you — technical brilliance without dental knowledge is worthless Overseas vendors create a compounding problem: HIPAA exposure, unverifiable security standards, and zero recourse if something goes wrong with your patient data Giving API access…

Ash Toub, Co-Founder of Smile Data and Ponce Dental Studio, brings a rare dual perspective to dentistry, currently running both a dental group and a software company built for dental groups. After helping scale a 28-location DSO to $10–12M in EBITDA, he developed a proven 5-pillar framework for building dental groups that survive and scale.Most dental groups aren't failing because of bad marketing or poor clinical care. They're failing because they built a skyscraper on a house foundation — and didn't realize it until the cracks started showing. Key Revelations: The 5 Pillars of a Scalable Dental Group Ash’s 5-Pillar Growth Framework: People → Data → Infrastructure → Revenue Cycle → Marketing. Miss one pillar, and growth becomes expensive chaos. Marketing Only Works on a Strong Foundation: More leads won’t fix broken operations. If your people, systems, and collections aren’t dialed in, marketing only amplifies inefficiency. Data Without Definitions Is Dangerous: Dashboards alone aren’t enough. If KPIs are…

David Janash, Founder & CEO of Underbite Dental, built a 13-location DSO from the ground up in one of the most brutally competitive markets in the country: New York City. He's made every expensive mistake in the book — and turned those mistakes into a data-driven operation that actually tells him what's going to happen before it does. David used to log into every single office manually, every single night, just to know how his business was doing. Then he spent hundreds of thousands of dollars building a custom data warehouse and hiring software engineers to solve the problem. He eventually scrapped all of it for a monthly software subscription that does it better. The lesson isn't just about wasted money — it's about what happens to your strategy when you're operating without real insight. David coined it himself: "The map to that gap is your data" Key Revelations: The Gap Between Intention and Actuality Most DSO leaders are obsessing over last month's report — the operators winning right now are looking at…

Tonya Christal and Danielle Powell of Lee Dental Centers in San Antonio don't have a fancy training platform, a DSO war chest, or a playbook they borrowed from a conference stage. What they do have is something far rarer — a 40-year family practice, a sister who's also their business partner, and the hard-won clarity to know exactly who they are and who they're not. The hard truth? Most dentists are building their practice to look like someone else's. They're scaling because the seminar said to scale. They're chasing new locations because four feels small now when it used to feel big. And somewhere in that race, they stop asking the one question that actually matters — is this the life I actually want? Key Revelations: Designing Your Group on Purpose At four locations, you're constantly asking: Are we good? Do we need to get to ten? Are we just keeping up with the Joneses? Sacrificing EBITDA on purpose isn't a failure — sometimes it's the exact right move to protect your team, your time, and your sanity The…

Sean Hamel, Founder & CEO of Art of Dental Marketing, tears apart the broken cycle that's quietly draining dental practices dry — and most owners don't even know it's happening. Every dentist has hired a marketing company. Most have hired several. And yet the phone still isn't ringing the way it should. Sean reveals why the problem was never your marketing budget — it was the message. When every practice looks the same, sounds the same, and posts the same stock photos of people in scrubs, the only way to stand out is discounts. And discounts attract the wrong patients. And the wrong patients feed a cycle that burns through marketing companies, money, and momentum — over and over again. The hard truth? Patients aren't choosing you because you're clinically superior. They already assume you are. What they're actually buying is how you make them feel — and almost no one is marketing that. Key Revelations: What Patients Are Actually Buying When every practice looks and sounds the same, discounts become the only…

A Czech-trained oral surgeon walks into Wisconsin dentistry — and quietly becomes the guy everyone calls about implants. Dr. Jan Bublik has spent nearly 30 years watching general dentists hold themselves back from a procedure they're more capable of than they've been led to believe. He pulls back the curtain on the unspoken rules that keep dentists small, and the community-first model that's changing how implant education actually works. Key Revelations:The Cross-Training Effect Sending a patient to a specialist without knowing what to ask for doesn't guarantee a better outcome — it just moves the responsibility Long-term patient trust is a clinical asset. When you've earned it, expanding your scope becomes a natural conversation, not a hard sell The dentists who grow aren't necessarily the most technically gifted — they're the ones who surrounded themselves with the right people and kept learning 💡 The "Ask Dallin" Question:"How do you objectively evaluate provider performance using data without relying on…

Dr. Rehan Shahid, multi-practice owner, dental coach, and COVID-era graduate, reveals an uncomfortable truth about modern dentistry: dental school teaches clinicians how to drill and fill — but not how to run a business. As a result, many highly skilled dentists unknowingly build practices that struggle financially because they lack leadership systems, data-driven decision making, and business fundamentals. Key Revelations: The Business Education Gap in Dentistry Many Dental Owners first see their financial statements from their CPA and don’t know how to interpret profitability, overhead, or where money is leaking. Dental school teaches clinical dentistry, not how to run a business. Yet successful practices depend on systems, leadership, financial management, and operational structure. Most dentists graduate with almost zero training in reading financial statements, running KPIs, or understanding business operations, even though many will eventually own a practice. Execution beats perfection in business.…

Sarah Ruberg, CEO & Founder of Our Thrive Tribe, delivers an uncomfortable wake-up call to every dental professional playing it safe on the sidelines: the industry is full of people with powerful stories, hard-won expertise, and genuine wisdom — and almost none of them are sharing it. In a world drowning in AI-generated noise, your most underutilized competitive advantage might be the most human thing about you: your voice. Key Revelations: The Personal Brand Blind Spot Nobody Talks About Most dental leaders don't post because they believe "nobody cares what I have to say" — yet that silence is costing them relationships, opportunities, and revenue You can say everything about yourself without saying anything about yourself — promoting others reveals your character, values, and mindset louder than any self-promotion ever could Waiting for your marketing department to build your brand? Sarah's message to salespeople: you are the differentiator — not your product In business, personal brand and relationships…

Dr. Anushka Gaglani & Dr. Abhishek Nagaraj of Aero Dental Group exposes the uncomfortable truth about what's really breaking dental groups from the inside — and it starts the moment you make your first hire. Two dentists who grew from a single struggling $200K practice to a multi-location group share what they've learned the hard way: the new associate entitlement crisis is real, it's wrecking your cash flow, and most DSOs are too afraid to say it out loud. Key Revelations:Hiring Mistakes That Cost You Years Most are walking into interviews asking about bonuses and guarantees before ever discussing how to get better clinically Want to make $300K? You need to produce close to $900K–$1M — a number most new grads have never heard and aren't prepared for Sign-on bonuses aren't gifts — if you don't perform, the group finds a way to get it back. Every time. DSOs competing for D4 students with perks are creating a false sense of leverage before they've treated a single real patient 💡 " The "Ask Ken" Question:"Why…

Bonnie Thompson, COO of Forest Family Dentistry and 37-year dental industry veteran, delivers an uncomfortable truth that no AI vendor wants you to hear: the biggest crisis in dentistry isn't technology — it's that leaders have forgotten how to lead people. While inboxes overflow with AI pitches promising to "fix" your practice, Bonnie exposes why practices keep burning through staff, why change management keeps failing, and why blaming "nobody wants to work anymore" is the laziest — and most dangerous — thing a dental leader can say. Key Revelations: The People Problem No Software Can Solve Employees don't quit companies — they quit leaders who roll out changes without buy-in or training Managing a Gen Z team member looks nothing like managing a Gen X or Boomer — and most leaders have no idea what to do differently Turnover isn't a "them" problem. If your team keeps leaving, the first question a real leader asks is: what could I have done better? The difference between ego and insecurity — and why confusing…

Jake Larsen and Clint Berry, Co-Founders of Kolla, exposed the dental industry's data hostage crisis: While Google made Gmail free to capture YOUR data and built an empire worth hundreds of billions, dental practice management systems are charging YOU to access YOUR OWN patient data - and in the age of AI, it's getting worse. The dirty secret? Some PMS providers are locking down data not because of costs, but because they've found a "clear path to revenue" by holding practices hostage. Key Revelations:The Data Gatekeeping Scandal Formerly open-source systems now charge third-parties for write access after closing their code On-premise PMS providers actively lock doctors out of databases on hardware THEY OWN Cloud-based systems charge up to $100/month PER LOCATION just to access your own data via API PMS providers set arbitrary API prices with "no relation to actual costs" - it's pure profit extraction, not cost recovery 💡 The "Ask Ken" Question:"I'm afraid of my financial statements every month. I fear the…

Herb Ford, VP at Risk Strategies Dental Practice (Brown & Brown Company) and longtime insurance industry insider, exposes the silent killer of emerging dental groups: catastrophic insurance gaps that owners don't discover until the lawsuit arrives. While multi-location practices celebrate growth and expansion, they're unknowingly operating with fractured liability coverage - associates control the protection for million-dollar corporations, general agents miss dental-specific risks, and one credit card decline can leave an entire DSO completely exposed to financial ruin. Key Revelations:The Professional Liability Disaster Waiting to Happen Thinking "my associate has their own coverage" means you've handed control of YOUR practice's protection to someone else Group professional liability policies give you control over protection + group discounts, yet most multi-location owners don't even know they exist 70% of emerging DSOs keep using the same insurance structure from their single-location days - it doesn't…

JW Oliver, Founder of SupportDDS with 40 Years in Dentistry, Reveals Why Your Labor "Solution" is Making Things Worse: The dental industry's obsession with AI and automation is backfiring spectacularly - practices are hemorrhaging the human connection patients crave while throwing technology at problems that don't need tech fixes. Key Revelations:The AI Hype vs. Reality Check The question isn't "Can AI do it?" but "Should AI do it?" - and practices are finally asking the right question Initial phone calls from new/existing patients - 90% of callers frantically demand a real person within 30 seconds when greeted by AI Treatment consultation conversations - Patients spending $700-$50K on dental work want empathy, compassion, and a human voice they can trust Appointment scheduling with questions - Bots can't read emotional cues or address anxiety that keeps patients from booking 💡 The "Ask Ken" Question:"My accountant says my numbers are fine, but why do I still feel broke?" Ken's answer: "Fine" means tax…

Thomas Passalacqua, dental leadership coach and former educator, reveals the uncomfortable truth about dentistry's hidden crisis: While practices obsess over financial metrics and operational systems, they're ignoring the emotional tsunami drowning their leaders—resulting in chronic overthinking, executive paralysis, and the industry's staggering attrition epidemic that no salary increase can fix. Key Revelations:The Emotional Crisis Destroying Dental Practices From the Inside Out First-time CEOs and executives are drowning in self-doubt but hiding behind the façade of success Acquisitions fail not because of P&L issues—they fail because DSOs ignore the emotional shift Without trust, transparency, and relationship-building with associates, managers, and support teams, you get lawsuits, broken promises, and mass attrition The antidote: Build relationships FIRST, then discuss equity—culture fit beats financial fit every time 💡 The "Ask Ken" Question:"What's the biggest financial mistake growing dental groups…

Vince Dilley, Founder & CEO of Platinum Dental Services (bootstrapped DSO since 2012), drops truth bombs about dentistry's ticking time bomb: succession planning through private equity-backed DSOs. While everyone chases valuation multiples and arbitrage plays, doctors are sleepwalking into retirement disasters - discovering too late that their 40% equity rollover is now worthless, the new operators can't maintain performance, and investors expect them to keep working years beyond their planned exit. Key Revelations:The Succession Planning Crisis Doctors drive the ship, DSO provides support - not the other way around Doctors fixate on upfront valuations but ignore the fine print: rolling 40% equity forward with ZERO guarantee it maintains value New DSO operators often underperform original owners, destroying that rolled equity Associates are the key to organic growth, yet many DSOs don't align incentives for them to become partners 💡 The "Ask Ken" Question"Is cash basis accounting actually hurting my practice…

The Membership Plan Trap: Why 88% of Your Cash Patients Disappear (And How Bad Accounting Is Killing Your Practice) Paul Lowry, CEO of Dental Menu, reveals the brutal truth about dental membership plans: Most practices are accidentally running discount Groupons instead of sustainable membership programs - farming PPO patients while hunting cash pay, watching 88% of uninsured patients vanish within 5 years, and unknowingly creating accounting disasters that pit hygienists against the plan and destroy practice valuations. Key Revelations:The Discount Plan Death Spiral Practices create fake procedure codes (999) and adjustment codes, making daily production never match collections Study of 250,000 new patients proves: Without prepaid benefits, patients delay until pain, then disappear out the back door Most "membership plans" are actually annual Groupons that patients buy to close treatment, then abandon Write-offs disguise fraud: Office managers put friends/family on plans, and no one catches it 💡 The "Ask…

Matthew McGaw, founder of DSO Compass, drops a controversial truth bomb: The dental conference circuit that once drove industry innovation has become a pay-to-play scheme where vendors buy stage time, authentic value has been replaced by Instagram theater, and attendees are walking into rooms with 6 people seated in spaces built for 1,000. Post-pandemic, connection now matters more than content - but most conference organizers haven't gotten the memo. Key Revelations:The Forced Conversation Trap Attendees aren't going for education anymore - they're going because they're terrified of missing their "piece of the pie" in the great dental consolidation DSO executives rank vendor CEOs dead last on speaker preference - yet they're the only ones who can afford keynote slots. DSOs are sending regional managers instead of C-suite decision-makers - vendors are paying premium prices for conversations that go nowhere 💡 The "Ask Ken" Question: "How do I know if my DSO is ready for private equity interest?" Ken's answer:…

Gabe Hoffman, operational efficiency coach and former DSO director, drops a truth bomb the dental industry desperately needs to hear: Your culture isn't failing because of team lunches or pizza parties—it's dying from gossip, indirect communication, and the cancer of unresolved conflict. With 50% of every dollar going to people costs, most groups are hemorrhaging profits through toxic communication patterns they don't even recognize. Key Revelations:The Culture Tax Nobody's Calculating Reality check: Most leaders waste hours managing rumors instead of driving results Turnover can explode from 10% to 30%+ when communication breaks down Ken's framework: The "straight talk" principle: Address issues directly or waste thousands in management time managing rumors Great culture isn't built with perks—it's built through accountability and direct communication 💡 The "Ask Ken" Question: "What's the best way to benchmark my DSO against others?" Ken's answer: Stop obsessing over other people's numbers. The best…

David Harris, CEO of World's Largest Dental Forensic Accounting Firm, Drops a Bombshell: 70% of Dental Practice Owners Will Be Embezzled—And the Bigger You Grow, the Worse It Gets. David Harris reveals the shocking truth dentistry doesn't want to admit: If you own 20 practices, there's an 80% chance someone is stealing from you RIGHT NOW. The digitization of payments didn't make dental practices safer—it created a goldmine for thieves. That "gold jar" in your operatory? It holds $15,000 while you obsess over the $800 cash drawer. And here's the kicker: 100,000 serial embezzlers are circulating through dental practices across America, hopping from office to office because DSOs are too hungry for "experienced" staff to screen properly. Key Revelations:The Guardian Who Steals Most embezzlement in dental practices is committed by the office manager—when the guard steals and has no oversight, they get away with it every time Reports are abstractions—thieves exploit "selective reporting" to hide their tracks DSOs…

Louis Chan (Kaylie.ai CEO) and Jonas Sison (Kaylie.ai CFO) shut down the industry's biggest AI fear: At a DEO conference, someone asked if AI could "fire their RCM team" - the answer reveals why that DSO is already failing. The real threat isn't automation replacing humans; it's leaders who don't understand that AI exists to eliminate "unsuitable for human use" tasks (like calling insurance companies 40 times a day) so your team can finally focus on patient experience and edge cases that actually move the needle. Key Revelations:AI Won't Fire Your Team (But This Mindset Will Kill Your DSO) The Tribal Knowledge Crisis: 20 years of denial insights and appeal strategies trapped in office managers' heads—when they leave, decades of intelligence vanishes because it never escapes departmental silos. The $100K+ Fee Mystery: Practices tell patients "80% covered" without knowing if that's your fees or insurance's UCR, then surprise them with $300 bills after fighting denials—forcing a choice between one-star reviews…

Francesca Pregano's 30% Growth Formula: Remove Insurance Drama From Your Front Desk + AI-Powered "Wheel of Retention" Francesca Pregano, COO with 19 years in dental, discovered the real reason multi-location practices bleed patients: It's not bad dentistry - it's front desk staff drowning in insurance conversations they can't win. Her radical solution? Strip all financial chaos out of the office entirely and give the team one job: make patients feel welcome and collect the right data. Key Revelations: The Wheel of Retention That Doubled Profitability Created remote RCM team to handle ALL financial conversations outside the practice, tracks Day Sales Outstanding and audits the entire revenue cycle Training front desk staff to explain complex insurance processing was impossible with high turnover. Front office now focuses solely on: collecting patient data, creating happiness, and guiding patients through the visit Insurance companies' post-rollup data disasters were destroying collections, patients don't care…

Ken Kaufman & Nathan Chitty dive deep into the first 4 episodes of Dental Truth Project - uncovering the game-changing insights from industry legends Brian Calao, AJ Peek, Eric Roman, and Gareth that every DSO leader needs to understand. The brutal truth about advisors flooding into dental for easy money, why the "highest bidder" might bankrupt your equity rollover, and the associate dentist management crisis that's quietly destroying DSO profitability from the inside out. Key Revelations: Legends Perspectives Brian Colao's warning: "If you can't get along with your affiliated dentists, you don't have a business." The good ones who stay are amazing. The replacements? Disaster. A.J. Peek's equity killer: The highest bidder is also the closest to defaulting. Push your multiple too high, and one missed covenant wipes out your rollover equity. Eric Roman's uncomfortable truth: Dentists refuse to coach other dentists—and it's hurting patients, associates, and profitability. Gareth Petsch's market reality:…

Nathaniel Baker, Overjet Key Account Executive, drops truth bombs about why DSOs and dental tech companies keep missing the mark: Most DSOs are "organized chaos" that don't have their act together (even the biggest ones), industry partners are pitching products without understanding what success actually means to each stakeholder, and the #1 reason pilots fail isn't the technology - it's that nobody agrees on what winning looks like. Key Revelations: The Alignment Problem in DSO Operations Ask a CFO, COO, and Chief Clinical Officer what success looks like - you'll get 3 completely different answers Pilots fail because DSOs don't take true ownership - "it's just a pilot, we'll shake hands if it doesn't work" KPIs don't stick - DSOs jump from one metric to the next without staying in the fight Procurement managers hit with decision fatigue start hiding their "dirty laundry" from vendors 💡 The "Ask Ken" Question: "What's the single most important financial KPI for a DSO?" Ken's answer: Free cash flow.…

Alex Sharp, CEO of Shared Practices Group, exposes the hidden cause of dental burnout: You're stressed because you're trying to be everything to everyone. The dentists thriving right now? They've niched down, gone deep on one thing, and escaped the hamster wheel. The Amazon model of dentistry (crowns, fillings, root canals, sleep apnea, ortho aligners, implants - all in one day) is literally designed to burn you out. Here's why the narrow path is actually the profitable one. Key Revelations: Why Simplicity Actually Scales (And Complexity Kills You) "Simplicity scales. Complexity doesn't." - If you're juggling 15+ procedure types, you're a jack of all trades and master of none Case presentation friction: Team isn't fluent in procedures they rarely do. The result: Longer appointments, more stress, inconsistent patient experience Dentists panic about consolidation like it's game over. The real opportunity: Niche players will always emerge because specialized service beats commoditization 💡 The "Ask Ken"…

Maria Melone, former KPMG auditor turned M&A advisor with 100+ dental transactions under her belt, exposes the valuation myths costing dentists millions: "Percentage of collections" isn't a valuation method - it's just a reference point. Unqualified brokers are flooding the market with misleading valuations. And here's the kicker: the exact same practice sale can legitimately be framed as 28x, 15x, or 8x EBITDA depending on the calculation method - yet most dentists obsess over the multiple while completely ignoring the other side of the equation. Key Revelations: Sale Process Dentists Get Catastrophically Wrong The Direct Solicitation Trap: Buyers make unsolicited offers attractive specifically to prevent you from going to market and creating competition The Advisor Imposter Crisis: Former dental sales reps are now calling themselves M&A advisors without valuation training or deal experience The Buyer Pool Gap: 25-50 buyers vs. 2,500+ buyers = massive value left on the table before you even negotiate The…

Howard Polansky, former practicing dentist turned financial strategist, exposes a controversial debt elimination system that has CPAs arguing and dentists gasping: One client freed up $190,000 in annual cash flow in a single hour without changing a thing about their practice. The secret? "Velocity banking" - strategically using lines of credit to reverse-engineer the tools banks use against you. Key Revelations: The Line of Credit Revolution Traditional debt traps you with fixed payments until you die Your line of credit becomes your checking AND savings account - money flows for YOUR benefit, not the bank's Strategic use of lines of credit can eliminate 12 years of debt in just 18 months Paying extra principal on loans creates a dangerous liquidity trap 💡 The "Ask Ken" Question: "What's the fastest way to know if my DSO is overstaffed?" Ken's answer: Look at two key metrics. First, staff costs as a percentage of collections - if you're spending more than 28-30% of your revenue or collections on staffing,…

Josey Sewell, Former DSO COO and Clinical Leadership Expert, Reveals Dentistry's Uncomfortable Truth: Nobody Wants to Manage the Doctors. Josey Sewell pulls back the curtain on the industry's most avoided conversation: Despite building org charts for hundreds of dental groups, she's never seen a hand immediately raise when it's time to fill the clinical director seat. The excuse? "Dentists don't need to be managed." The reality? Associates are starving for mentorship while groups burn through talent, and female dentists are being systematically bullied by teams—yet leadership turns a blind eye because they're too afraid to have the conversation. Key Revelations: The Clinical Leadership Vacuum Associates crave feedback and mentorship, but dentist-to-dentist relationships are so broken that even reviewing clinical work feels impossible Dentists won't coach other dentists because they assume "what I know, you know"—massively underestimating their own expertise and leaving associates to drown When building org…