The Most Profitable Services You Could Be Overlooking

Intro
This is The Thriving Dentist Show with Gary Takacs, where we help you develop your ideal dental practice—one that provides personal, professional, and financial satisfaction.

Gary Takacs:
Welcome to another episode of The Thriving Dentist Show. I’m Gary Takacs, your podcast co-host. Uh, the title of today’s episode is The Most Profitable Services You Could Be Overlooking.

Well, I think this is gonna be a great episode for, um, our listeners at every stage of their career—whether you’re early stage, mid stage, or late stage. Uh, I think you’ll have a lot of things you can take away from this episode.

Um, I have, um, one, uh, quick introduction to make before we get into today’s episode. Uh, in our, uh, Thriving Dentist Marketing Tip, uh, we have, uh, Naren Arulrajah, my co-host for this podcast. He is gonna share a marketing tip with you.

And that tip is: What is the dental practice journey in 2025, and how can you optimize it for your success?

Well, with no further ado, here’s Naren and the Thriving Dentist Marketing Tip.

Naren Arulrajah:
Hi, everyone. This is Naren, the co-host of this podcast and the founder of Ekwa Marketing. Today, the tip that I’ll be sharing with you is: What is the Dental Buyer’s Journey in 2025, and how can you optimize for it?

And the reason this is important is, once you understand how dental buyers go about finding you and choosing you, the more likely you are able to optimize for that journey and get the most number of new patients.

Today, more than 90% of patients start their research on Google. They either are learning about different doctors, different providers, or they’re learning about a particular topic. So they start their research—they start typing things into Google.

So step one of the dental buyer’s journey is: are you showing up, or are you not showing up? You could show up through ads, or you could show up organically—meaning, you show up as one of the free listings at the top of Google search results.

Now, the advantage of organic is they trust you, right? Because nobody goes to Google to see the ads. They go to Google to see the organic. So, because they don’t go to Google to see the ads, they don’t trust you when you run an ad.

So, if you run an ad, keep in mind you run marketing. The rest of your marketing funnel has to be really well tuned, and you will be spending five to six times more—at the very least—in terms of how much you’ll spend to get a new patient.

But if you’re a startup practice—great idea. If you’re trying to use it temporarily to, like, top up—great idea. But I wouldn’t make Google Ads my primary source because it’s so expensive—like I said, five to six times.

So now, step one is to be found on Google. Uh, that’s how most people start their journey. They don’t ask their friends. They don’t—you know, because, you know, we feel ashamed to ask people about information today, because people will be like, Haven’t you heard of Google? So those habits that we used to have in those days are gone.

Um, then once they find you, then they are—they have to decide whether to come to you or to go to your competition. And typically, Google will show, uh, 10 results organically on page one. And of course, there’ll be so many more ads on top of that.

So the key is: are you helping them like you and choose you?

So how do you get them to like you? A few things you can do on your website to get people to like you is, you know, on your About the Doctor page, About the Team page—provide personal information. Like, if you have a picture of your family, show that. Why? We like people who are similar to us.

So, let’s say I am a parent—a dad or a mom. I see you as a, you know, person with a young family—I will immediately feel some type of liking towards you because we have something in common.

Um, so same thing with your team—you know, include their hobbies, include some fun pictures.

Uh, so that’s on the liking side.

Now, how do you get people to trust you? That’s where Google reviews come in. Both—um, you know, just continue to get 10 or more Google reviews every month. That should be the minimum target.

And then leverage those reviews and highlight them on the relevant pages. So, if I’m on the implant page, you know, if I can see actual Google-verified reviews talking about, you know, the amazing work you did in implants—that’s wonderful.

And another way to build trust is to have before and afters. You know, think of them as cases. The most important picture when you are including pictures from the dentistry you do is the full-face after picture. They wanna kind of visualize themselves being transformed.

I know not everyone is gonna be comfortable sharing full-face before pictures. So even if you don’t have those—no worries. But definitely start collecting full-face after smiles, and start highlighting them. Start explaining what happened.

Because those who are serious—they will go through those pictures. They will look at what you have written up in terms of why the patient came, what they wanted, and what you did.

So here are some tips:

Step one is to optimize helping people find you.

Step two is to optimize helping people choose you.

Uh, if you want to have us do an in-depth study of how you are using these techniques on your website, on your marketing—book a marketing strategy meeting. It’s a $900 comprehensive review. It’s our gift to you.

We spend several hours researching you, your competition. We’ll give you a, kind of a, um, report card as to where you are—where you are today in all the different parts of marketing.

And more importantly, we will give you a roadmap, a plan. The link is ekwa.com/td.

Naren Arulrajah:
Welcome back to the Thriving Dentist Coaching and Action Segment. This is Naren, your co-host again. Hope you enjoyed my tip on the dental buyer’s journey.

If you have any questions, book that marketing strategy meeting: ekwa.com/td, and we would love to answer all your marketing-related questions—and of course, your dental patient buyer’s journey questions.

Um, now let’s jump into today’s episode, which is an awesome topic. And the reason I’m really excited about this is I believe in working smart. And today’s topic is all about working smart.

The topic is The Most Profitable Services You Could Be Overlooking. The Most Profitable Services You Could Be Overlooking.

Gary, I know you—we have been working together for a few years. We have had mutual clients for almost, like, close to, you know, more than half a decade now. And, uh, one of the things you do is you help your clients boost their profits, and you have many, many, many, many strategies.

One of the strategies is: many people don’t charge enough. In other words, on a percentile basis, they’re charging way less than what they should be charging, given their skills and expertise.

The other thing you do is you focus on, you know, identifying a few types of services that help them add a couple of hundred thousand dollars to their, you know, revenue top line—and a hundred, a hundred and fifty thousand dollars to their bottom line.

Uh, you know, it could be sedation, it could be, you know, uh, Invisalign, it could be any kind of high-value service.

So I’m really intrigued about what you have learned, Gary, over the last 44 plus years now, uh, in terms of the most profitable services, the do’s and the don’ts, and what they are.

And let’s just dive in.

Gary Takacs:
Yeah. You know, I think every dentist—uh, every practice owner—is certainly interested in improving their profitability.

And there’s a lot of dragons out there, uh, kind of, uh, eating away at practice profitability. The biggest dragon out there are the PPO plans. Uh, you know, when, when you’re giving away 45 to 50% of your hard-earned money to the fat cats of the insurance company, uh, that’s definitely eroding your profitability.

But there’s other dragons too. Um, inflation. Uh, we’re—we’re in an era where inflation is increasing, especially wage inflation in, in, in dentistry. Uh, wage inflation is going up radically. Um, and to be competitive, you have to offer, um, favorable wages, uh, in your community, or you simply won’t get applicants.

Um, and, you know, uh, I’ve made it, um, my life’s work to study world-class practices. Forty-five years of experience studying world-class practices.

And Naren, I’ve yet to meet a world-class practice that didn’t also have an incredible high-performance team. You know, if you don’t have that high-performance team, you’re not gonna get that—that world-class practice.

So, uh, but when you have wages—you know, wage inflation—and, and wage inflation is—is eroding at your profitability, um, we’ve gotta figure out ways to counteract that.

So that’s why we, um, percolated this topic for this, uh, podcast: The Most Profitable Services You Could Be Overlooking.

And I’m gonna share three categories, uh, of—of services that I believe will fit every one of our listeners one way or another.

Um, and I’m gonna start with the first one that absolutely applies to every one of our listeners.

One of the best ways to increase your profitability is to focus on same-day dentistry. Same-day dentistry.

Gary Takacs:
Now, same-day dentistry has two meanings, uh, in dentistry. One is, if you’re using CAD/CAM or a mill, that’s often been—if you’re doing a crown and you’re able to prepare and seat the crown because you have a milling technology in your practice—that’s been called same-day dentistry. And, and that is a correct definition of same-day dentistry.

But that’s not the definition that I’m using. Uh, the definition that I’m using is: you have patients in your practice today—they may be in hygiene, they may be, uh, having some minor things done in restorative—that there’s an opportunity to add more dentistry to help complete their treatment plan.

Or, if they’re in hygiene, maybe it’s a patient that, um, has, uh, fillings on the upper left remaining to be completed as part of their treatment plan. And we could talk to that patient about staying after their hygiene appointment and completing those fillings for us while they’re here today.

Uh, Naren, every human being on the planet—the most valuable commodity that they have—is their time. Would you agree with that?

Naren Arulrajah:
Absolutely, Gary. I think, um, you know, everybody—everybody, yeah. I mean, uh, we are very conscious of the little time—I mean, you and I—the older we get, the more conscious we are of it.

Gary Takacs:
But even, say, a college student—you know, uh, where you think, Oh, well, today they have lots of free time—well, a college student can have, uh, a great appreciation for their time. If we can save them a trip and utilize some insurance benefits that they have, that can be a pretty easy presentation to make to the patient—saving them time and utilizing some benefits that they have.

So, same-day dentistry—the reason why it’s so profitable is you’re now growing your practice. You’re growing your daily production compared to what you had on your schedule when you came in.

And if we can grow your practice—if we were able to, by adding same-day dentistry, just that technique alone—let’s say we’re able to grow your practice $100,000 a year.

I’m using a round number ‘cause it makes my math really easy. We’re gonna be doing this with the same team and the same hours.

Expenses fall into two categories: fixed or variable.

Fixed expenses are those that—just as the title would imply—stay the same no matter what. An example of a fixed expense would be your rent or your mortgage—that’s the same regardless of what your production is.

Almost all dental expenses are fixed. Even your wages are fixed. You tend not to think of your wages as fixed, because it’s not the same number every month depending on the hours and the number of workdays. But essentially, it’s a fixed expense—it’s within a fixed range.

So, we’re gonna be growing your practice with same-day dentistry—same team, same hours. We’re not adding more hours, we’re not adding more team members to do it.

And, and I’m using the goal of $100,000 a year. Your fixed expenses all stay the same.

The only expenses that go up are variable. And the variable expenses are those that are a function of doing more dentistry.

There’s really only two categories of variable expenses in dentistry:

Your lab bill (if you’re using an outside lab)

Your consumable supplies

If you’re doing more dentistry, you’re going to use more consumable supplies.

Makes sense, Naren?

Naren Arulrajah:
Yes.

Gary Takacs:
Yeah—do more dentistry, we need more materials with which to do that.

So let’s talk about the lab.

My budget for lab will depend on whether you’re a CAD/CAM or a mill office. If you’re a CAD/CAM or a mill office, do not drink the Kool-Aid and believe that you’ll be doing everything with CAD/CAM and everything with a mill. You’ll still be using some more limited outside lab services.

So my budget for an office that has CEREC or a mill is 4%.

If I use the percentage, it’s a percent of your revenue—a percent of your collections. Not a percent of your expenses, but percent of your collections.

So 4% for lab if you’re a CAD/CAM office.

It’s 8% for lab if you send everything restoratively outside—if you send your crowns to a lab.

And then my budget for consumable supplies is the same across all practices: 6%.

You should be able to keep your consumable supplies to 6% or less.

So let’s add those up. Let’s assume you’re not a CAD/CAM office, so I’ll use the higher number:

8% for lab

6% for consumables

That adds to 14%.

Now, theoretically, nothing else goes up.

But we know that’s not how it works in the real world. In the real world, other minor expenses go up—maybe because we’re growing the practice we use more toilet paper.

So maybe the toilet paper expense goes up. I’m being silly, but let’s just add a 6% miscellaneous budget to make a round number.

8 + 6 = 14, +6 = 20%.

That’s your expenses on those growth dollars.

If you’re doing the dentistry yourself—as a solo doc, owner-doc practice—you’re 80% profitable on those top dollars.

Naren, can you think of many services that we do that are 80% profitable?

Naren Arulrajah:
Not really.

Gary Takacs:
No. They don’t exist!

But here they are. And what could they be? Same-day dentistry could be:

Fillings

Root canals

Crowns

Minor services

The other thing we can do with same-day dentistry is be able to see emergency patients the same day and do some treatment.

Maybe it’s palliative care just to get them out of pain. Maybe we have the opportunity to do more definitive care like root canals and extractions.

So, adding not only same-day dentistry on our existing patients in your schedule, but also being more accommodating to emergency patients.

And Naren, I think there’s mixed sentiments among dentists about emergency patients. Some think they’re a blessing, some think they’re a curse.

I think the reality lies somewhere in between.

But I would like to change all of our listeners’ mindset and start thinking about emergency patients as a tremendous opportunity.

If you can get that patient out of pain, you’re their hero.

Yes.

If you can work them in—the language should start on the phone when someone calls and says, “I’m experiencing a toothache. Is there any chance I can get in today? I’d be a new patient.”

A lot of times it shuts down right there.

Right, Naren? I mean, we’ve listened to calls.

Naren Arulrajah:
Yes.

Gary Takacs:
And it’s like, “Oh no, we could never get you in today.” Clunk.

But in the morning huddle, you could identify a morning emergency appointment and an afternoon emergency appointment.

So that way, if you get that call, we’ll know where we’re gonna put them in.

Sometimes it’s not easy to identify that, but that emergency patient would be willing to wait a little bit because we’re working them into the schedule.

So, find a time in the morning, find a time in the afternoon.

And then sometime during that appointment, say to Bob, the emergency patient:

“Bob, I’m sorry you’re experiencing this pain today. I’m sorry you’ve been having trouble. You’re coming into our practice as an emergency patient today. I’m glad we could get you taken care of.

Before you leave today, I’d love to talk to you about coming in as a regular patient.

What we would do is gather some records, take a look at your mouth, and troubleshoot to avoid these kinds of things from ever happening again. Bob, are you open to that?”

What do you think most of the time their answer’s gonna be?

Naren Arulrajah:
Absolutely.

Gary Takacs:
Yes. Absolutely.

So now we added production to the schedule and added a potential new patient to the schedule down the road.

Naren Arulrajah:
So let’s kind of, um, I just wanna make sure I understood the key points, Gary.

Step one is: When you can add dentistry without adding extra people or hours, your margins go up—80%.

Gary Takacs:
Well, it’s 80% based on our math.

Naren Arulrajah:
Yeah, exactly. So that’s the secret. What you’re saying is everyone is showing up for that day—the patients are showing up. What if you can do some extra work on current—

Gary Takacs:
—patients? So the key would be to have your hygienist identify every patient in their schedule who has unscheduled treatment in their treatment plan.

Naren Arulrajah:
Right?

Gary Takacs:
Right. So they’re gonna say in the morning huddle, “Here are my patients today that have unscheduled treatment.”

We’re gonna look and see if it’s possible—based on the doctor’s schedule—to work that patient in.

Then we’re all gonna be on board for that.

The hygienist will suggest it:

“Gary, I know the doctor recommended fillings for you on that upper left. I’m concerned about those. Those fillings are failing. And if they fail to the point where you experience pain, the treatment may be a lot more extensive—like root canals and crowns.

Now that’s good for us, but not good for you. It would be good to get those fillings taken care of.

I know you’re scheduled for hygiene today, but at the end of your appointment, we could move you over to the doctor’s operatory and doctor could do those fillings for you today—saving you a trip.”

Now, that won’t work 100% of the time.

But Wayne Gretzky had a great quote around that: “You miss every shot you don’t take.”

Naren Arulrajah:
Exactly.

Gary Takacs:
Let’s take some shots—see if any of them go into the net.

And by the way, if they say no—it doesn’t work, “I have a meeting I have to get to”—then we have an opportunity to schedule them subsequently.

Your admin team was in the morning huddle. So if it turns out we’re doing it today—great.

But if not, she can suggest to the patient:

“Let’s get those scheduled at a time that’s going to work for you coming up.”

That’s one way.

The second way is identifying morning and afternoon emergency appointments.

Naren Arulrajah:
I see this all the time, Gary.

They say, “Oh, you’ll wait two days,” and the patient goes somewhere else. I hear this on phone calls day in and day out.

Gary Takacs:
The third way is to add ancillary services—services done by your assistants:

Whitening

Delivering Invisalign trays

Making night guards

Delivering night guards

On the Invisalign trays, the doctor has a role—but it’s relatively minor. Most of the work is done by the assistant in delivering the trays.

So look at adding ancillary services.

So there’s three things you can do to add same-day dentistry:

Tune into patients with unscheduled treatment in hygiene and see if they can stay.

Work in emergency patients (morning and afternoon slots).

Add auxiliary-driven treatment to a side column in your schedule.

Now let me add two more areas that are profitable services you could be overlooking:

Expanded Hygiene Services
By expanded hygiene service, I’m not talking about cramming in more cleanings in your hygiene schedule.

Not what I’m talking about.

What I’m talking about is getting serious about diagnosing and treating conservative perio therapy.

Your hygienist can experience 3 to 4x hourly production by doing perio therapy, by doing expertise—

Naren Arulrajah:
Three to four X—that’s amazing.

Gary Takacs:
Three to four X. And there is a way to evaluate how you’re doing analytically.

The way to evaluate that is to look at all the adults in your practice. And across the adults in your practice—you know, there is such a thing as juvenile-onset periodontitis, but it’s mostly a disease of adults. So, look at the adults in your practice.

According to the experts, 30% of your adult patients should be treated with some mix of conservative periodontal therapy codes.

There are four specific codes:

4341 – a quadrant of SRP (Scaling and Root Planing)

4342 – a quadrant where three teeth or fewer are involved in SRP

4355 – a gross debridement

4910 – periodontal maintenance

So the experts say that in any practice—assuming a normal age distribution (meaning your practice isn’t overly young or overly elderly)—then 30% of the adults should be treated with some mix of those codes.

You can pull those codes and look at how you’re doing.

Naren, recently I did this for a client of ours. We pulled the codes—with his permission—and I asked him, “Hey, how do you think you’re doing in terms of periodontal therapy?”

He said, “I think we’re doing pretty good, Gary. Um, I think so. We could probably get a little better, but I think we’re doing okay.”

I said, “I have a way of actually analyzing and looking at it for you. Would you like to know how you’re doing analytically?”

He said, “Yeah, I’d like to.”

Remember, the benchmark was 30%. This office, over a three-month period of time, had 10% of its adult patients receiving conservative perio therapy.

So he was doing one-third of the goal.

Naren, how is that on a report card?

Naren Arulrajah:
He’s an F.

Gary Takacs:
That’s failing.

Here’s the thing—he thought, and he goes, “Oh my gosh, we’re asleep.”

To his credit, he didn’t deny it or get defensive. He just said, “Oh my gosh, we’re asleep at the wheel. We need to correct that.”

Naren Arulrajah:
I think one of the things that I notice with dental practices is—they’re not numbers people.

Just having a goal, a number—now you know whether you hit it, didn’t hit it, how much you missed it by—you can do something about it.

It’s just a habit, right?

I know you do this with all your coaching clients, Gary. You have KPIs, you have numbers that they try to achieve every month, every quarter. And now they know: pass/fail.

If fail—what can we do?

So it becomes almost like a game. It’s not hard work anymore.

And also, it’s divide and conquer. The doctor’s not doing everything. All the team members are pitching in.

Gary Takacs:
Really, what’s happened in hygiene is—over time—the hygiene department has kind of devolved into simply doing prophy.

Yeah.

And you’re not serving your patients if they have an infection in their gums. You’re not serving your patients by cleaning their teeth when you know they have an issue in their mouth that could affect their systemic health.

So this is about taking care of your patients.

By the way, if any of you would like help evaluating that—determining that 30%—I can help you do that.

If you’ve got Dentrix, Eaglesoft, or Open Dental, I can help you do that.

Schedule a coaching strategy meeting. We can make our meeting focused on that.

And you’ll see massive improvement—not only numbers-based—but you’re going to be helping more of your patients become systemically more healthy as a result.

Gary Takacs:
And then the third area is a broad category, but consider adding an appropriate mix of high-value services.

The way you would pick your high-value services is: pick the things you like to do.

By high-value services, I’m talking about:

Placing and restoring implants

Adult orthodontics

Cosmetic dentistry

Sedation (whether oral conscious or IV)

Complex restorative dentistry

Sleep dentistry – diagnosing and treating obstructive sleep apnea with appliance therapy

All of those services are more productive per unit of time than everyday general dentistry.

So you’re going to be increasing your profitability by doing more of those high-value services.

Well, Naren, I took a look ahead to see what our questions were. We’ve got some great questions coming up.

Let’s hit pause here and get to the Thriving Dentist Q&A Segment.

Naren Arulrajah:
Welcome back to the Thriving Dentist Q&A Segment. This is Naren again.

I really enjoyed The Most Profitable Services You Could Be Overlooking.

Gary covered three buckets of services:

Same-day dentistry – fitting more patients in, either patients who are already on your books or emergency patients.

Periodontal therapy – enhanced conservative perio services.

High-value services – and this could be whatever you like.

For some, it might be Invisalign. For somebody else, it could be veneer cases.

So whatever you’re passionate about, that requires skill, extra training, and typically creates an outcome that the patient is looking forward to—like a beautiful smile—that’s what fits into this bucket.

So Gary, I learned a lot. You gave lots of tips. But now I’m going to ask you questions that our audience sent in, linked to these types of high-value, periodontal, and same-day dentistry services.

Very first question:
How do I pick the best service to add to my treatment mix in 2025?

Gary Takacs:
That’s a great question.

Yeah, because I’m not going to answer it in a generic way.

There isn’t a high-value service that I think all of our listeners should do.

The reason I’m not going to answer it that way is—I’m going to take it in a different direction.

And the different direction is:

What is a high-value service that you would be excited about taking 1,000+ hours of CE for over time?

Not right away, but imagine—over a period of years, maybe 6, 7, 8 years—what is something that you would be excited about pursuing over a thousand hours of CE for?

What would that be?

For some doctors, it might be cosmetic dentistry.

They look at that and say, “Oh, I’m in. There’s so many different things you can do in cosmetic dentistry.”

Gary Takacs:
And every time—uh, you know, maybe it’s a doctor that’s a member of the AACD, the American Academy of Cosmetic Dentistry—and that doctor goes every year to the annual convention.

They literally are like drinking from a firehose from all the speakers—like David Hornbrook and others.

And they come back rejuvenated, and they’re starting to look for other courses they can take between the AACD meetings.

So really, the way to answer that question is:

What is a service that you would get excited about taking over 1,000 hours of CE in?

If the answer is XYZ, then that’s the high-value service you should add.

If it’s something like, “Well, I’m interested in it because there are a lot of people in our town who need it,”—I wouldn’t go that direction.

Because if you don’t enjoy doing it, you probably aren’t going to be very good at it. And all the CE is going to be a grind.

Dentistry comes in lots of different flavors.

There’s got to be something—or several things—clinical treatment areas that you would love to add to your practice because you’re excited about mastering your clinical excellence in those areas.

So that’s the way to answer the question.

Naren Arulrajah:
Thank you, Gary.

Actually, this doctor said "best service"—he wasn’t just referring to high-value services.

Would you recommend same-day dentistry and periodontal therapy for everyone? Or even those—would you?

Gary Takacs:
Well, you know, if you think about what’s the foundation—uh, you know, what is the foundation of a successful general practice?

The foundation that I like an awful lot is everyday general dentistry—all the things that fall into that bucket.

Because by incidence, you’re going to see a lot of that—fillings, root canals, crowns, extractions, whatever.

And then a really strong hygiene department.

That’s the foundation—that’s like the foundation of a building, before you build the structure on top of it.

And the foundation is everyday general dentistry combined with a really strong, thriving hygiene department.

Then, the building on top—you know, the icing on the cake—would be whatever high-value services you choose to do.

You’d pick those based on things you really like to do.

But in terms of the first bucket of services you could be overlooking—everything that relates to adding into our practice today—it’s likely to be everyday general dentistry.

That’s what we can add into our practice practically.

Naren Arulrajah: So you mean same-day dentistry? Pretty much.

Gary Takacs: Same-day dentistry.

Naren Arulrajah: Got it. Got it. And that’s going to fall into everyday general dentistry.

Gary Takacs: Every day.

Naren Arulrajah: So you’re saying that is like mandatory. Got it.
Let me go to the next question, Gary.

Question number two: I like your suggestion on adding same-day dentistry. How would you recommend making this happen in my practice?

Gary Takacs: Hmm. Alright. We have a whole coaching protocol for that. Um, and there, it literally is—there’s a number of moving pieces around that. Um, the first thing that you have to do, we’ve gotta, we’ve gotta have a functional morning huddle to identify opportunities in our schedule today. Uh, and opportunities would be unscheduled treatment from hygiene, PA. So we’ve gotta have a morning huddle.

In the morning huddle, the hygienists have to come to the meeting prepared to talk about patients on their schedule that have unscheduled treatment. Um, and then you’re gonna look at that as you go through the morning huddle. And you’re gonna look over at your schedule and see if, let’s say the patient’s a nine o’clock hygiene patient—we finish hygiene at 10. At 10 o’clock, could we move that patient over to the doctor’s side and do some dentistry that day?

Gary Takacs: It’s not gonna be possible a hundred percent of the time, but there will be times where you could absolutely do that. So, morning huddle—hygienist prepared to talk about unscheduled treatment on the patients in their schedule. And then, perhaps most importantly, doctor needs to embrace a can-do attitude about adding in same-day dentistry. And doctors, I’m gonna be blunt about this, and it’s simply an observation. Don’t shoot the messenger here. I’ll be the messenger. Don’t shoot the messenger.

I noticed the doctors fall into one of two camps when it comes to adding same-day dentistry: can-do doctors—"Yep, we can do it. Yep, you bet. We got it. We got it. We got it. Yep, yep."—and, "Oh no, no, no, no, no. We can never do it." Now, my observation is more dentists fall into the can’t-do attitude because of your rigid training.

Gary Takacs: Mm. Rigid training around, you know, around structure. Around structure. Um, but man, if you can pivot, if you can change that and have a can-do attitude around that, practices that are thriving around adding same-day dentistry are where the answer is yes. The answer is, "Oh yes, we can do that."

In states where your hygienists can administer anesthetic, that will be helpful. ‘Cause now, hygienists could pop over, could deliver anesthetic while you’re doing the hygiene check, and then you can jump over. Also, training your assistants to allow everything they’re allowed to do under your state practice act. Don’t violate that. I’m gonna repeat that: don’t violate your state practice act. Don’t allow an assistant to do something that they’re not allowed to do. The risk involved around that is too great.

Gary Takacs: Don’t do that. But train them to do everything they’re able to do right up to the practice act. Um, and that might happen over time. Um, and then start looking at opportunities to say yes.

When you have the opportunity to add treatment, you know, if a hygienist tees it up for you and then you come into the hygiene room, and the hygienist says to you, "Dr. Paul, Gary’s interested in learning if he could stay today to do those fillings on the upper left. He’s got some flexibility in his schedule. We could move him over to your schedule. Is that gonna work?" If you say no a bunch of times to that in a row, what is that gonna feel like to the hygienist who’s teeing it up for you?

Naren Arulrajah: I mean, I think they’ll stop doing it, right? I mean, like—

Gary Takacs: How many times do you have to bang your head against the wall to stop banging your head against you?

Naren Arulrajah: Exactly. Exactly.

Gary Takacs: Yeah. But if you say yes, then we start building a culture of possibility around this. Then I know it’s not possible a hundred percent of the time, yeah, but I think if you adopt some of the things that we’ve talked about—training your assistants to do everything they’re allowed to do, having your hygienist deliver some anesthetic—and remember that that patient, if it’s an emergency patient, they’ll be willing to wait a little bit because they know you’re working them into the schedule.

So, I think it’s just a matter of, you know, efficiency, team member support, and then a can-do attitude. Those three things make the difference in terms of practices that are successful with it versus practices that maybe it happens a little bit but not enough to move the needle.

Naren Arulrajah: Thank you, Gary. Great—

Gary Takacs: Question, though.

Naren Arulrajah: Yeah, absolutely. I was gonna say, you had mentioned for those who are interested in improving profitability, they could book a coaching strategy meeting. The link for that, if anyone is interested, is thrivingdentist.com/csm.

Now, I have watched, Gary, I’ve watched our mutual clients. A lot of these ideas look amazingly easy when we listen to a podcast or hear about it, but the devil is in the details. I mean, a lot of the things, like for example, if you’re trying to implement same-day dentistry, it’s a process Gary goes through with the practice because there’s gonna be so much of inertia that stops it from happening. And what Gary does is slowly untangle that inertia till you get rid of all those reasons why it doesn’t happen and happen. Well, it won’t be reality.

So, I mean, but the good news is, I’ve seen practices just on same-day dentistry alone make an extra $300,000 in revenue and $250,000 to the bottom line. It’s crazy how powerful this is. It sounds so easy, Gary, like in a one, but just unreal—just one idea alone could make an extra quarter million dollars in profits.

Gary Takacs: Then there’s a term in physics called veloce. Veloce means that once you’ve expanded your mind into a new realm, it doesn’t shrink back up and go back to the way you were. In other words, if you’re an office that historically has produced $5,000 a day—and I’m just making a round number up, right?—and then you grow to a point where your office over time creeps up to where now you’re producing $10,000 a day, you don’t go backwards. You have that new velocity, you know, capability in your schedule. It’s like expansive. Look it up. Look it up under AI. Look up the concept of "izing." And that applies here. And next thing you know, you’re really radically improving your practice.

Gary Takacs: And one more tip—and this has to do more with leadership. When it comes to rallying your team members around this, we can certainly rally around numbers, and we could have a bonus system. There could be some way to reward that, yes. But I think what’s even more important than that is every time we talk to our patient—our team—about growing and doing more dentistry, we talk about it in the context of serving the patients.

Do we serve a patient that has unscheduled fillings by having that patient stay today and completing those fillings today and perhaps utilizing some insurance benefits, because it’s early in the year and they’ve got benefits left? Are we serving that patient?

Naren Arulrajah: Absolutely. I mean, you saved that mom or dad a trip, an extra two, three hours of their day, and they did something they had to get done anyways, because it’s like if you don’t do it, if you ignore it, it’s gonna cause all kinds of problems.

Gary Takacs: So let me tie that to another statistic. Mm-hmm. I discovered a new association lately. And the association that I discovered was the American Association of Dental Plans. And this is an association of insurance company executives, right? By the way, I have no intention of ever joining that association—just for the record. Didn’t know they even existed, right?

But here’s a piece of data that they published in terms of the annual award—you know, the maximum benefit available in a dental plan—and that could be $1,000, could be $1,200, it could be $1,500—hasn’t moved much since they started that in 1968 at $1,000. There are many plans that still have a $1,000 annual max no matter what. But here’s the data—and this is published by these plan executives: only 2.8% of patients who have dental insurance utilize their annual max.

Naren, I said that right. 2.8%. Let’s call that 3%. Where’s the other 97% of their annual award going?

Naren Arulrajah: Uh, going into the—

Gary Takacs: Pocket of the—

Naren Arulrajah: Pocket of the insurance company. Exactly, yeah.

Gary Takacs: Is it going to the insurance clerk at Delta? No, no, no, no, no, no. It’s going to the executive committee. Yeah. So they’re not gonna raise their annual award when only 2.8% are ever used in the annual award. But we could help individuals use their annual award, right? And now, so that’s how we can serve our patients. And then, by the way, the numbers follow when we serve our patients. Just a minor but important point.

Naren Arulrajah: Absolutely, Gary. Thank you for that. Really appreciate it. Let me go to question number three, Gary. Can you describe a step-by-step process I can use to attract more new patients for Invisalign?

Gary Takacs: Alright, I’m gonna flip that to you, Naren. That’s, um, that’s in your ballpark. Um, so let’s make it Invisalign specific. What can an office do to start attracting more people that are interested in Invisalign?

Naren Arulrajah: Yes, a hundred percent. Let me address that. So, step one is: let’s get the strategy right. So, strategy meaning, how are you gonna attract new patients? Obviously, 95% of new patients today come from digital. So within digital, there are four buckets: SEO, Google Ads, social media ads, and free social media—what’s called organic social media.

Organic social media—lean into it. If you are an influencer, meaning you love the camera, you’re spending 15 to 20 hours, you have tens of thousands of followers, or you are willing to get to tens of thousands of followers, then lean in. My experience is 1% of you—because I work with hundreds of doctors—are in that category of people who love being influencers. If you’re in that 1%, lean in. That’s a great idea.

If you’re not in that 1%, then you have three options. Two are ad-driven—Google Ads and social media ads—and then SEO. The ads are, in my experience, five to ten times more expensive. Really simply, they don’t trust ads, right? They clicked on an ad, they—the minute they’re clicking—they’re asking the question, "What’s the catch?" That means they’re looking for a reason to not call your office, not book an appointment. And even if they do, they may not show up. So for that reason, I would only do it as a top-up strategy.

The only exception being startups where you need a lot of new patients and you don’t care—even if they’re costing you $500 or $400 a new patient—you will pump money into ads. So SEO is a strong strategy. I personally believe it doesn’t work for everyone, but the top 5% get 95% of the free traffic from Google. So I really think every one of you listening can get into the top 5%.

Naren Arulrajah: It takes a year. And how do you know you’re in the top 5%? Just find out how many keywords you’re ranking that are in the top 10 results—i.e., page one. If you’re ranking for a hundred or more keywords, you’re in the top 5%, you’re getting 95% of the free exposure from Google. But if you’re not, then you need work to do.

So anyway, that’s in general what I would do. So I would focus on SEO if you’re not in that 1% influencer type, and then I would top it up with ads. Now, within that, let’s talk about Invisalign specifically.

Now that you’re a strong SEO practice, you’re ranking for 100+ keywords. There’s gonna be at least 30 to 40, maybe even 50 keywords related to Invisalign. I’ll give you some examples:
"Invisalign dentist near me,"
"Best Invisalign doctor,"
"Best Invisalign doctor [zip code],"
"Invisalign dentist [city name],"
"Neighboring [city name],"
"Invisalign before and after,"
"Invisalign gone wrong"—you know, all kinds of things to do with Invisalign. Some people might even type in "braces." So there are all permutations and combinations. Typically, there are 50 of these keywords.

You should have access to Google Analytics. It’ll tell you what these keywords are, and it’ll tell you, in a 30-day period—the last 30 days—how many people typed in that keyword. And it’ll also tell you what your average position is.

Naren Arulrajah: So once you collect, say, 50 keywords, more than likely you’re not gonna be ranking for these—you need to work on it. So obviously, do the general things that make you strong with SEO, and then start focusing on these particular keywords, building landing pages for those keywords.

Add before and after pictures—ideally full-face pictures—where you can show the transformation on those landing pages. So people see it and say, "Wow, I can get that smile. I can get rid of my crooked tooth. I can look like that person who looks very similar to me."

So add those cases, maybe even add a video or two. Make it really friendly—45 seconds. Welcome them. Have them look around the page. Invite them into your practice. Credential yourself.

Now, before they even call, they go to Google, they’re looking "Invisalign," you keep showing up again and again and again. And then they go to the landing page. They love what they see. They love the cases. They love your, you know, kind, welcoming, down-to-earth video. They feel comfortable. What happens? The phone is ringing.

That’s when Gary comes in and his coaching comes in—to make sure the phone is answered properly. Now you have a complete solution to solve your need to attract new Invisalign patients.

If you want to learn more on the marketing steps and the details and how you are doing, book a marketing strategy meeting: ekwa.com/msm.

Gary Takacs: Awesome, Naren. That is the key. And next thing you know, you’ll be ranking for Invisalign. One of the reasons I am agnostic when it comes to brand of aligners—we don’t have any relationship with any of them—but I do like Invisalign because it is the only brand name that the public actually knows, right?

Invisalign’s done enough marketing to the public that the public—there are people that will search not just for adult orthodontics, but they’re gonna search for Invisalign. But you know, if you choose any of the other clear aligners—no harm, no foul. There are keywords, key phrases around those too. But something to think about is that Invisalign does have brand recognition.

It’s kind of like, Naren, Kleenex.

Naren Arulrajah: Yes.

Gary Takacs: You know, "Can you hand me the Kleenex?" Kleenex is a brand. It’s not just a tissue. So if you want that kind of recognition, then do Invisalign.

Naren Arulrajah: Absolutely. And the same thing can be applied to veneers. Same thing can be applied to—fill in the blanks. The same process can be applied to any one of the high-value services.

Yeah. Let me ask you the question number four, Gary. That’s my last question for you. My hygiene department is somewhat stuck. What are some tips you have that will help us embrace more conservative periodontal therapy?

Gary Takacs: Naren, if I had a $50 bill for every time I’ve coached a practice that was stuck in hygiene, I would own an island in the Caribbean. It would be next to Richard Branson’s island. But my island would be a whole lot bigger than Richard Branson’s. It’s just common. It happens over time. It sort of morphs into, "All we’re doing is cleanings."

And I think assisted hygiene lends itself to that. You know, when you’re seeing 16, 18 patients a day with an assistant, it leads to just more of that. That’s why I’m not a big fan of assisted hygiene. It can be done, and it can be done well, but it often goes against trying to be more comprehensive.

When it comes to adding conservative periodontal therapy, what I recommend doing is doing a recalibration meeting—doctor with you, or if there are other doctors in the practice, the doctors and your hygienists—and sit down and determine how you want to really define your conservative periodontal therapy program moving forward.

Gary Takacs: Recalibrate—whatever it was, recalibrate to where you want it to be. Read the book together: Beat the Heart Attack Gene by Dr. Bradley Bale, MD. He’s an MD, right? Read that together. That will get a common alignment between your doctor—or doctors—and hygienists.

And then talk about: what’s your probing protocol? You know, what is it? How often do we repeat it? And then talk about diagnosis. Talk about case types.

The AAP—the American Association of Periodontists—came out with new case typing guidelines in 2018. They’re really valid. I would recommend you follow those guidelines. So, in other words, when we see this, this is the case type.

And then determine what is within your realm of treating in your practice. Maybe it’s Case Type 1, 2, 3. And maybe if it gets to Case Type 4—where those would be pocket depths 7 or greater, lots of gum recession, lots of bleeding, lots of mobility issues—maybe that’s something we refer out. But maybe we’re going to treat Case Type 1, 2, and 3.

Gary Takacs: And then determine, within each case type, what is the treatment protocol? For early gingivitis? For early periodontitis? For moderate periodontitis? What is the treatment protocol?

Determine if you’re going to use ancillary services like site-specific antibiotics, like a laser, like maybe salivary diagnostics, and just get everyone on the same page.

And that might take a series of meetings between doctor and hygienist. But the end result is you’re going to now transform what was nothing but cleanings into really state-of-the-art, today, how we diagnose and treat conservative periodontal therapy.

It’s a project. It’s worth it. And it’s really worth it in terms of making an impact on your patients’ overall systemic health—not just the health of their teeth and gums.

Any of you guys wanna talk about that, go to thrivingdentist.com/csm and we can talk specifically about that. I can share all the things I don’t have time to cover today. We can cover that one-on-one in a coaching strategy meeting with you.

Well, now, this was a fun episode: The Most Profitable Services You Could Be Overlooking. Doctors, a request on our side—if you have a colleague, someone you went to dental school with, maybe someone you enjoy taking CE with—share this episode with them. They’ll thank you for it.

Yes. On that note, thank you for the privilege of your time, Naren, and I look forward to connecting with you on the next Thriving Dentist Show.