Tips and Tricks

Let’s get ready to rumble with another episode of AmericaSmiles: Tips, and Tricks. In today’s episode, I want to talk about how to raise your prices and raise your fees for your dental lab. It’s a real sensitive subject. It’s a challenging subject to approach. Most people are scared to death to raise their prices. Some aren’t. 

I’ve worked with a lot of labs and my busiest labs, on average, are my most expensive labs. To them, I say, “Let me guess, you’re on the higher end of the scale”. They inevitably always are. So anybody can race to the bottom, but let’s get rid of that theory. Should you be high? Should you be low? Should you be middle? Let’s wipe that out; everybody has talked about raising their prices.

For the sake of argument, let’s say you, the viewer, have not raised your prices in some time or are hesitant to do so, and perhaps you are wondering if you should announce your price increase. But let me as you a question; Does your dentist notify you when he’s raising his prices? “Hey, I just want to let you know that I’m making more money selling your crowns at 1500 bucks a crown today!”. No, they’re not telling you that. So, they raised their prices and they’re putting that cash right in their pocket. And! They’re not worried about notifying you. With that in mind, should you inform them? Should you not? There are arguments on both sides personally. But, I never have. I’ve always just raised my prices. I have always found, personally, that advertising a price increase is bad PR.

Now, let’s discuss how to go about letting people know about raising your prices. Most people would agree that you’re better off announcing a price increase, but here’s the deal. When you’re talking to the doctors about a price increase, you got to speak to them about a couple of other things too. First of all, you’d rather not work than work for free; it’s tough to make a lot of money in the lab. You’ve got to explain to them, that to grow your business and continue to increase your value proposition to that dentist, you need to be able to grow at the pace of business and the needs of the market. That requires having the liquidy to expand your staff, invest in the latest equipment and in innovations that could improve how you do business together.

You may want to have a model department. You may want to have designers. You may want to have people run your mills and you’re competing with 15 and 20 bucks an hour at Walmart and at Amazon making good people that you can afford hard to find. Remind doctors that in the last 15 years, 13,000 laboratories have closed their doors. In the past, we had 18,000 labs in the US. Today, there may be between 5,000 and 6,000. On top of that, lab techs and workers are deciding there are easier ways to make money. So when you add all that up, the number one consideration for your dentists is this: restorative dentistry is their cash cow. Therefore, they’ve got to support you. You’re their partner in restorative dentistry; the most valuable part of your practice. How else are they going to pay off those student loans?

So you’ve got to make the point to the doctor who has reaped the benefit of the speed and communication working with your local business. Yes, they can go to Glidewell, but that is going to come with more compromises. Sooner or later, they’re going to rue the day when the local lab is gone, and they’re at the behest of a faceless corporation that makes no concessions or considerations for their small practice. Again, you’re their partner. Is that dentist really prepared to end that partnership over a fair and likely, long-coming price increase that amounts to a modest percentage of the whole transaction?

Speaking in dollars and cents, if a doctor is getting a thousand bucks a crown and you’re charging a hundred dollars, it’s only 15%. He’s got a 15% expense on his thousand. If you were to increase your rate to 180 bucks a unit, he’s going to say, well, that’s a 20% increase. Yeah, it might be a 20% increase, but it’s still only 18% of their expense, amounting to only a 3% price increase on their bottom line.

As lab techs, we are skilled tradesmen. We can find other work if push comes to shove, but can that dentist say the same, and is it worth the risk over so little? Will those corporate labs be so considerate? 

You have to learn to speak to these guys this way. Let’s save the dental lab industry! Let’s keep quality technicians. Let’s get the price we deserve. Take them by the….uh…we’ll call them guts. Raise those prices. 

That’s all I got for today’s AmericaSmiles, tips, and tricks.

On today’s episode of AmericaSmiles, Tips, and Tricks, we discussed the easiest way to get new dentists to try your laboratory. The best tip I can give you to bring in new dentists is to utilize the AmericaSmiles One Voice program. So, I’m going to explain to you what One Voice is and give you a little bit of its “Genesis” (That’s a little plug for the zirconia!).

How One Voice Began

The fact of the matter is that for most dental laboratory owners, the weakest area of their business is marketing and advertising. I explained on a previous episode of Tips and Tricks that marketing should be just as predictable as sending out statements, ordering supplies, or anything else that you do on a daily or weekly basis. So, I recognized this weakness in the lab industry a long time ago and I started what was called America’s Smiles. 

We had an American Smiles membership program that we did called Direct Connect. I realized that most laboratories don’t reach out to doctors. So, I started calling doctors on behalf of labs saying, “Hey, can I schedule a meeting for this guy’s laboratory to come out and meet with you?”

I would schedule the appointment, and the lab would meet with the doctor, show them the samples and the price list, and the labs got to close the deal and get them to commit. While the American Smiles Direct Connect program has been successful for the last 10 or 12 years, we gradually changed the program over time. 

We changed the name to what we call One Voice and started putting everyone on the same program. With the One Voice program, we would send out a postcard one, two, three months in a row to soften up that dental office. Then I would call and say, “Hey, you’ve heard of All Smiles Dental Lab, right? I’ve been sending you these postcards. Can I get you to schedule a meeting with this guy?” Eventually, I discovered that the lab guys weren’t keeping the meetings because they didn’t know how to close the deal or ask for a case. So, now we do that for you too. Today, we’ve got 12 people calling on behalf of over 200 laboratories, with what we call One Voice.

How the One Voice Program Works

So, here’s what we do. We send a postcard, introduce the doctor to your laboratory, and tell them about your special—maybe a $119 crown or whatever it is. We follow up with a phone call and ask them to give you a case and try out your lab. We save you time and you get new clients. It’s a win-win for everyone.

A Special Limited-Time Bonus

Now, for a limited time, there’s an added bonus: This May 31, right after Memorial Day, we’re going to give $10,000 to one lucky dentist.

Here’s how that will work. I’m going to send out a postcard to the nearest hundred dentists to your laboratory. I’m going to tell them about your lab: who you are, what your business name is, and what special you’re offering. Then we’re going to tell the doctor about our QR code. In case you don’t know what a QR code is, it’s a scannable square barcode you point your smartphone camera at. When you do that, a website pops up on your screen. The doctor follows that link to the website. He can register to win $10,000 in free services from your lab; no purchase necessary. I’m paying the bill. So, on May 31, one lucky dentist is going to win $10,000 from one lucky lab.

Double Their Chances of Winning

You may be thinking that my sales staff are going to lose their jobs. But you don’t need to worry because we still have stuff for them to do. When a doctor clicks on your QR code, we’re going to call them and say, “Hey, check it out, send this lab one case and you will double your chances of winning.” So, now instead of the doctor being entered once, the doctor is entered twice. 

And it gets better: if they send you a case and they’re selected a winner, it isn’t $10,000 anymore, it’s $12,000. So, how do we do that? We’re going to pay the bill. We tell that winning doctor to use your lab for four consecutive months. Whatever your lab bill is, we’ll pay up to $3,000/month. So, if the lab bills $500, we’re going to pay $500. If the lab bill for the month is $3,500 we pay $3.000. The point is, we’re willing to spend up to $12,000.

Sign Up for One Voice Today!

So, the easiest way to get a doctor to use your lab is to sign up for One Voice. We’re going to charge you $195/month for this service. In return, we’re going to send postcards to the nearest hundred dentists to your lab, or the next town over, if you prefer. The postcard is going to be an advertisement for you. It’s going to say, “Click on the QR code, register to win $10,000.” My team is going to follow up and tell that doctor to click on the QR code. If they send you a case, they will double their chance of winning $12,000.

So that’s it. Today’s episode of AmericaSmiles, Tips, and Tricks is a win for everyone—The doctors get a great, reliable lab, I get your business, and you get more clients!

Welcome to another episode of America’s Smiles, tips, and tricks. Today, we’re going to be talking about zirconia oven health. Now it sounds like my tip may be a funny topic, like, What do you mean zirconia oven health?

Where There’s Smoke, There’s Fire

When you’re cooking, the zirconia in the oven is hitting 2,700-2,800 degrees Fahrenheit, or 1500 Centigrade. It’s a crazy science lab happening in there. Now I’m not a physicist or a chemist, So I don’t know exactly what’s happening, but I know there’s a lot of violent stuff happening at 3000 degrees Fahrenheit similar to how water turns into steam at just 212°C. Needless to say, you don’t want foreign material to find its way into that. You want your oven to be clean to result in a clean product.

One of the discoveries we have made is that you must clean your oven as soon as it comes in. The ovens that we buy have this insulation, and the way it holds the heating elements rubs together and creates a dusty environment. When our centering ovens come in, we break them down and blow out all the parts outside, and you wouldn’t believe the dust cloud that comes from the manufacturer. If you have all that dust in there and then subject that dust to this violent atmosphere at 3000 degrees, it’s going to contaminate your teeth. So, number one, when you got an oven, clean it out. Number two, I believe every day or at least once a week, we blow our ovens and our muffler out with an air hose nice and gentle apply only minimal pressure. You’ll see the dust come out of there and blow out the top where you’re collecting dust.

One of the most critical mistakes we’ve encountered was a lab that called us because we sold them an oven, and they were expressing how crappy our oven is and that the teeth that were coming out were ugly. We found out he put his oven right next to the mill. So, he’s milling teeth and casting all the dust out into the oven, thus contaminating all the teeth in the oven. Keep your oven in a healthy, clean environment away from your mills. If it resides in a dusty area when it’s not being used after it cools, put a cover on it. Keep in mind you don’t want to melt the cover to the oven.

Cleanliness is Next to Profitability

Here are a couple of other tips we have. Number one, make sure you clean your teeth well. Okay. Dust and debris on your teeth are the number one thing to contaminate the coloring process. You’ll have a hard time getting good color penetration if you’re using classic white. Number two is if dust gets into the oven now you’re incorporating dust into the heating elements. To prevent this from becoming a problem, you can get what’s called a “Splay Event”, which is where you get this buildup of stuff on your elements, and then they break off, and you wind up getting contaminated zirconia. Do this every so often. Number 3, we use what’s called a deionizer to clean our teeth. What we found while trying to clean our zirconia while using a brush is that it’s like rubbing a balloon in your hair when you’re a kid; you get static electricity. The zirconia is actually building up static electricity, which is making the dust stick to the teeth. We blast our teeth so it breaks down the static electricity and helps you get all that dust off the tooth. 

Don’t Risk It. Test It.

When you fire your zirconia you want to test it. It’s kind of like the canary in the coal mine theory. Use some tiny chunks of zirconia on the top of your dish. If fired correctly, that zirconia should come out pure white. That’s how you know you have an excellent, clean oven. Our ovens have two dishes, so we have a top dish and a bottom dish. I put one chunk of virgin zirconia, no color in the bottom dish, another chunk in the top dish, then three more pieces on top. We call the three on top, junk zirconia. That stuff should be pearly beautiful white. That’s how you know you have a good, clean oven.

So once your teeth are colored, whether you have pre-shaded or color it yourself, once your teeth are colored, technically speaking, the teeth are contaminated with rust. That’s how we get the color to our teeth. We put oxides in there, which makes the teeth have color. So essentially, we’ve contaminated them. So use virgin white zirconia with a little on top and a little on each dish.

Keep your zirconia clean. Keep your ovens clean. Keep the oven in a clean area. That’s one of the keys to getting better quality zirconia.

And that’s it!

Welcome to another episode of AmericaSmiles, tips, and tricks. Today, we’re going to talk about handling your zirconia or managing your zirconia from mill to bill. Zirconia itself is very fragile, and one of the key things I’m going to focus on in this video is the cracks that may show up post sintering. So, when we’re dealing with machines or milling machines, these are technically CNC machines, which are new to the dental world, just for the record.

Good Vibrations 

CNC machines have been around for a long time as well as old school manual milling machines and other automated machines. So, when we talk about other industries using milling machines, they tend to look at our machines as little bitty toys that are not that special. Our machines have an x-axis, a y-axis, a z-access, and some of them tilt. So, you’ve got anywhere from three to five-axis, but these are all vibrating parts. You’ve got spindles that are spinning that can carry a little vibration. You can have a collet that can get loose and have a little vibration. You also have what’s called your “ball screws”, sliding back and forth as they get old and sloppy.

Troublesome Cracks

With zirconia being very fragile you can be incorporating cracks into your zirconia and never even notice it until post centering. The zirconia is a real chalky white, and you really can’t see a crack if it gets incorporated in there. So you want to make sure that your milling machines are in good, healthy condition by making sure your collets and spindles are relatively fresh. We change our spindles every six months, whether they need them or not. You don’t want to be incorporating a vibration gate and cracks that may not show up until they go into the patient’s mouth with a break in the patient’s tooth six months to a year down the road.

Inspection! 

Here at the AmericaSmiles milling center, we’re manufacturing about 200 to 250 teeth a day. We inspect every one of these cases underneath the microscope, looking for chips and cracks. A good indication of a bad spindle, collet, or cut is a long crack that runs along the margin straight up the access of the tooth. If you’ve ever dropped your handpiece down and you put a slight bend in that tool that you’re cutting out, you have vibration, and that tool you could be incorporating cracks into that as you’re cutting, and you don’t even know it. 

Inspect all these things. Post centering, look at them under the microscope. Otherwise, you may deliver something with a fracture. Sometimes, you have to rotate and twist them. There may be a cack you can’t see on one angle, and then you see it on another. You don’t want to deliver that case and have a crack later down the road. Make sure you’re always using a good sharp bur as well. We like something that’s got a little taper, like a 5-6 tapered unit. It’s important to have a good technique for cutting those things out. 

Know the Signs 

Ensure sure you’re not incorporating any cracks into that as zirconia. Then when you’re inspecting under the microscope, look for chips around the margins. If you’re seeing your chips are increasing around the margins, it’s a sign that you have bad collards or spindles. The secret to your zirconia case going from mill to bill is good, healthy milling machines, good cutting technique, and a good inspection post centering. 

And that’s it!

Welcome to America’s smiles tips and tricks. Today’s question to answer is, “How do you stop doing free remakes?” It’s a bad habit of the lab industry. I work with hundreds of laboratory owners on a monthly basis, and I don’t know how we got trapped into these notions of thinking that we’re the weak link, we have to keep our doctors at all cost, or if we charge for a remake, we’re going to lose our customers. The best way to stop doing free remakes is to change your attitude. I decided a long time ago that I’d rather not work than work for free.

Dollars and Sense

Let’s talk about some of the basic principles. If you’re getting (hypothetically) a hundred dollars for a crown, you’re running your business at a 10% profit margin. Therefore, if you do one remake at no charge, it’s wiped out the profits of the last ten units. In all honesty, you would have been better off if that case didn’t come in. Do only the previous nine, and hit the golf course. Keep in mind the cost of you doing a remake is much more dramatic than an upset doctor.

A doctor, on average, is charging about ten times the lab fee. Think about this for a second. Doctors charge a thousand dollars for a crown and pay you a hundred dollars. He can pay you to remake that thing ten times, and he still breaks even. Let’s not lose sight of that. The doctors have the margin to be able to absorb the remake charge.

Doctors are usually the weak link. Most remakes occur at the impression stage, and having the right attitude about remakes forgetting about the fear of losing a customer is critical. “Well, this guy does a lot of remakes with me, but I’ll lose the account.” Good. He’s bankrupting you faster than everybody else is. You have to have the right attitude about remakes. Let’s avoid remakes before they happen.

First Impressions are Everything

Let’s just say it’s the 25th of the month, and you have a bad impression for a six-unit bridge, and you’re like, “Man, I know if I hammered out this case I could bill it on this month and get paid, then say, having to wait 45 more days.” You know it’s a crappy impression. You will accept the impression because you want to get the case done. You want to bill it on this billing cycle.

Well, you’re doing a remake next month, and now, next month, you’re working for free. Stop these cases and bring them to the doctor’s attention. Show them what’s wrong with the impression. They gave you a six-unit bridge on a triple tray. Stop these cases before they become a remake, call them up, and then at that point in time say, “If you ask me to proceed, if this doesn’t fit, if you don’t like this case, I’m going to have to charge you for a remake.”

You tell them that upfront; make it clear upfront. Let’s insist on better impressions. I mentioned a triple tray for a six-unit bridge, so start telling doctors you need a full arch impression. Tell him you need more teeth to set an accurate bite. I was doing a case here recently as a protrusive bite. There was no occlusion to go for custom abutments in a case, so I don’t know where to put anything. I went back to the lab. The Dentist says we need a denture wax-up first approved for the incisal length for the facial fullness. Let’s get a doctor to approve of a lovely inexpensive slipper. Now we know where to go from there. Now we know where to place our custom abutments. Now we know where to put the rest of the case.

Partners in Profit

Stop these cases before they become a remake. The whole concept of reducing remakes is to change your attitude, understand the true cost and expense of doing a remake, and become partners with your doctors. You need to understand you are their partner in profit. Restorative dentistry is the most profitable part of a dental practice.

They can’t make enough money doing cleanings, fillings, and x-rays to pay their student loans back, restorative dentistry is what they need. They need a good healthy lab industry. Explain to them that you cannot work for free. You are in a position to exercise that power.

Understand if you’ve got six doctors, you’re learning at six times the rate those doctors are. They’re seeing only their patients. You’re seeing the patients of six clients. You’re really in a position of authority. It’s time we start exercising that authority.

And that’s it.

Welcome to America Smiles with tips and tricks where we try to help the average laboratory owner with some guidance on how to run their laboratory more effectively. The topic we’ll discuss is marketing-related; my favorite subject. More specifically, we’ll be tackling essential marketing tactics that all labs should be using.

Don’t Get Comfortable

Far too many laboratories find themselves in a situation similar to the one I’m about to describe. Say you’re a one-man lab with five or six doctors and are very comfortable with your situation. If you’ve just sat there and you’re not marketing and/or advertising, then you’re not running a business. You’re essentially working for five or six different doctors.

Your business is being run the way they want you to run it. Here at America smiles, we service somewhere around three to four hundred laboratories every month on a variety of different levels. I love all my customers want to keep all my customers, but the fact of the matter is we have an effective marketing campaign to get new customers. I get to be very, very selective. If I find out that I have a client that doesn’t fit what we’re looking for, we find a way to dismiss that client. That’s the reason I tell you that you don’t want to be in a situation where you’d be held to five or six clients.

If you have a two-man lab, you probably have 10 to 12 clients, a three-man team might be 18 to 20, but you don’t want to be beholden to any one of these customers. You want to be marketing and advertising so that you’re building and creating the business that you want while finding doctors that want to fit your business model. You’re not just gravitating. If I lose this guy, I will lose 10% of my business. You don’t want to be in that situation. How do you do that? Number one, have an attitude that marketing is just as usual and customary as sending out invoices and statements; you would never think of sending out a case and not having it include an invoice.

You would never think of the first of the month coming around, and you didn’t send out statements. Develop the mindset that it’s just as important to send out invoices and statements. If you start there, that’s 90% of it.

Where Marketing Begins

You can go out and do traditional door-to-door knocking on doors. You can do a mailing campaign. You can do social media. You can run campaigns with your other doctors and ask them, Hey, can you refer me to a friend? There are all types of ways that you could build a business. You already have more information than you might realize. Just look back. How did you get your first doctor? How did you get your first five or six doctors? Whatever you did, do that again, but with the mindset that it’s essential. The principal, most important reason is to build the business you want to own. Not just be employed by 6, 7, 8, 10 different doctors.

Nothing Can Replace Persistence

The method we recommend that we’ve found most effective is mass mailing if done right. The worst way you could do mass mailing is to put together a 5,000 piece mailer, send it out one time, and hope you get a doctor. All marketing has to do with brand recognition. You want a doctor to see your name over and over and over again. In truth, that may be what it takes to get them to pick up the phone. Think about how many times you have to see something before acting on it.

When Branding Pays Off

I like to brag about a doctor I got one time, Dr. Ed Vallish. He told me, “Keith, the reason I started using your laboratory is I thought I would see you less.” I was in his office so much. He figured the best solution was just sending me to work to keep me out of his office. He knew who I was. It took years to get him to try me, but there’s nothing wrong with sending out a postcard and to start with a small group of a hundred doctors, the hundred nearest doctors to your laboratory should all know that you exist. If I was to call and survey the nearest hundred doctors to your lab, they should all know who you are.

They say, yeah, we get his stuff all the time. The day their laboratory delivers a case late or fails to deliver it at all, a case doesn’t fit, or they go on vacation. You want that doctor thinking about you first. There’s nothing wrong calling all hundred doctors saying, “I’ve been sending you postcards for years. Is there any chance I could pick up a case as we’d love to do one case for you?” Or, saying, “I’ll do it half charge.”, if that’s what you must do to get the ball rolling. The main thing about having an effective marketing strategy is developing the mindset that you’re supposed to be doing it.

And that’s it.

Welcome to the America Smiles tips and tricks. We’re going to touch on various financial subjects, technical subjects, and marketing subjects. The whole idea of this program is to give you simple tips and tricks to help you run your business more efficiently.

For today’s installment, we’re going to discuss something in the marketing category with how to onboard a new dentist. If you’re onboarding a new dentist, we’ll operate under the assumption that you’ve engaged in a marketing program or plan, making door-to-door sales, using a mailer, or hired a call service of some sort.

Getting Started with a New Doctor

In any event, once you’ve gotten a new doctor to try you for your first case, they’ll send you just one case to get a chance to get to know the patient and to see how the case fits. Let’s assume that the first case is a crown and bridge. We’ll speak from a crown and bridge standpoint, but in this first case scenario, you might want to call the office immediately after receiving it.

When one of the employees answers the phone, ask if your case patient has been seen. If they confirm, yes, the patient’s been seen, you might want to ask, “Can I talk to the doctor? I want to confirm how the case went.” She might volunteer to ask the doctor for you. Be persistent to make that personal and technical connection with the doctor. Throughout my dental career, I’ve made a point of not talking to auxiliary staff on a technical basis, asking them how the contacts were. They have to ask the doctor; then it gets back to you.

Set the Tone

I like to talk directly to the doctor. Sometimes I even sound offended, saying, “I’m sorry, I won’t speak to auxiliary staff about technical issues.” I want to get right to the doctor the best I can. If you’re confident that the patient has come in, ask the doctor, “How was the shade? How were the margins? How was the context? How is the bite at this point? Is there any chance we can get you to try us for a couple of more? We understand that anybody can get the first case, right?” I’ve always said, “Be honest.” I want to make sure I like working with you as much as you like working with me. There’s no reason not to establish your ground that you’re not just begging for new business, that you deserve respect as a business owner, and you have standards and protocols that need to be met, as well as the customer.

Generally, I like to get 3 cases onboard. How do you bring a new customer into your fold? Talk to that doctor for up to five minutes, ask him how he liked the service with generally the same line of questions regarding the fit, the finish, and the aesthetics. If you’re confident that the doctors liked the work, it’s your opportunity to establish yourself as an individual business owner. However, I also need a quality impression from the doctor. I need the right amount of time to produce what you need, and I’m a stickler for being paid on time. If I can get those things from you, then I’ll go to the ends of the Earth to get a quality product to you.

Remake Policy

You can discuss how we all know that remakes are a part of the industry. I’m proud to say my remake ratio is about 2%, or about two out of every hundred crowns will have to be remade. I reserve the right to make a case twice and be paid once. The whole idea of businesses saying, “I didn’t like it, and I’m sending it somewhere else,” is never going to work. Take the opportunity to say, “Doc, I have a policy here for the most part. If we’re pretty confident the flaw was in the impression, I’ll do that case for half charge. If we’re pretty confident that it’s my fault, I’m going to be doing it at no cost”. But let’s be honest, the weak link in our system and dentistry is that impression.

I’ll try to hold a doctor to a high standard. I’ll try to give them feedback on the impressions they’re giving me. If something needs to be remade, I’ll let them know that an impression must be retaken and I’ll tell them that ahead of time. But in any event, it’s an excellent opportunity to establish yourself and say, “I’d love to do your work, but I am an independent business owner.”

It’s All About Customer Service

You have standards that you have to adhere to. It’s your opportunity to tell the doctor what your needs are as well as your willingness to provide him with anything he needs. Go over some of the additional services you offer, some timeframes, make sure they have enough lab prescriptions, and your price list.

Onboarding a doctor involves communicating after cases and showing you’re more than willing to provide all they could ever ask. Don’t forget; it’s also your opportunity to set your standards of what you expect from them as a business owner.