Dental Specialist Marketing and The State of Specialty Referrals Part 2

dental specialist marketing

Dental Specialist Marketing and The State of Specialty Referrals Part 2

We’re continuing the discussion of changes in referral patterns and how this needs to affect thinking on the specialist part as related to dental specialist marketing. Feel free to forward this article on to your specialist colleagues who can benefit.

Due to the trends discussed and that are well underway, specialists in growing numbers will be forced to embrace at least some direct to consumer advertising if they wish to not just thrive in practice but to remain independent. The ultimate primer for how to approach advertising any specialty service be it performed by a recognized specialist or a generalist with advanced clinical training can be found here.

Last week we covered the two biggest economic trends, dental insurance reimbursement and broad based middle class economic changes, affecting referrals. The outcome of these two trends is that more of the population which historically kept the average generalist busy enough so that he or she could easily and without substantial negative economic consequence refer out procedures, is shrinking. As a consequence, the average generalist looks at more ways to no longer refer out as many procedures and as a result they keep more cases for themselves and decrease referrals in an effort to maintain their standard of living.

It is a simple law of economics. One businesses “belt tightening” has a downstream effect on other stakeholders who have a relationship with the business including the specialist.

So those are the economic trends and impact let’s move on to the clinical trends.

Clinical Trend #1 – Decline in Periodontal Disease

10 years ago the president of the AAP stood up at the lectern at their national meeting and essentially said “because of declining disease rates and the broad use of inflammatory disease fighting statin drugs, as periodontists we’re going out of business unless we reinvent our specialty.” At the time this was as a very controversial statement among periodontists and yet a decade plus after his statement the trend has continued in the direction he forecast.

Clinical Trend #2 – Quality and Availability of Advanced Post-Graduate Education






Ruddle Endodontic Courses

Sclar All-on-4


The Misch Institute and others are all synonymous with extended or in-depth educational programs that elevate attendee abilities to perform more complex treatment.

Previously much of the knowledge contained in programs like these could only be acquired in a formal academic setting and previously the purview of mostly specialists and a very limited group of generalists. Now generalists and specialists can fast forward their learning around a specific procedure, around specific areas of interest, or elevate themselves as a “super dentist” in command of high functional skill sets in every major clinical interest.

Mid to late career generalists often find their excitement for dentistry reinvigorated after attending a more specialized clinical training. New dentists with foresight or mentoring are also now prone to take their skills to a high level quickly following their undergraduate educations.

Clinical Trend #3 – Management of More Severe Perio Cases by GPs and Hygienists

In addition to the declining inflammatory disease rates, more hygienists and generalists are trained and very comfortable at managing severe or chronic periodontal disease. Additionally, more practices have moved to laser based therapies which further improves the ability to stabilize cases non-surgically.

Clinical Trend #4 – Consumer Embrace of Better, Faster, Cheaper Clinical Options

The rule of better, faster, cheaper applies to all for profit business including clinical dental services. Look at any specialty or niche procedure area and the fastest growing segment within the niche are the ones that combine at least two of these three things.

Here are just a few examples:

In perio, practices investing in surgery reducing technology such as soft tissue lasers and treatment protocols have benefited (better and faster).

In implants, practice embracing speed oriented procedures delivering teeth on the same day as implants have benefited.   All-on-4 when done well, also allows the practice to charge less for an arch of treatment. (faster and cheaper)

In orthodontics, practices embracing speed based treatments have benefited (faster).

Even in what is now thought of as a mordibund procedure by most clinicians (dentures), better and faster has come into play.

It should be noted that any clinical procedure that is better, faster, or cheaper automatically provides a market place advantage for use in EITHER dental specialist marketing or in marketing by the generalist.

An additional resource that helps the clinician to understand patient behavior when it comes to specialty services and fees can be found here.

Clinical Trend #5 – Implant Manufacturer Focus on Market Share

Another clinical trend is one that is happening as a consequence of implant companies efforts to increase market share.

Nobel and Zimmer continue to look for ways to meet company and product growth targets. One way they do this is to heavily target their efforts at getting more generalists trained to do their own implant surgery. Getting the broad generalist market doing single and simple multi-teeth surgeries will dramatically boost their implant unit volumes and their surgical kit sales.

While no longer releasing annual numbers of dentists in training, as of 2006,

Nobel had trained 245,000 professionals at their training centers. In addition, Nobel has spent at least $15M across 18 dental schools to make sure undergraduate students have exposure to the surgical phase of implant treatment which of course means exposure to their products. This has already had an effect on the numbers of generalists starting to place their own implants.

As much as the word paradigm is overused, the paradigm of the team concept of implant treatment in the US has changed as a consequence of manufacturer focus on training. Up until recently, U.S. dentists were mostly unawares to the fact that in the rest of the world generalists were placing most of the single tooth implants. The continued educational push will continue to gradually make this a universal reality.

The sum results of these clinical trends in disease, technology, consumer preference, and education all point to more procedure capabilities and higher levels of procedure skills occurring within a larger and growing group of generalists. There has never been a larger group of highly qualified clinicians in the history of the profession and the direct consequence is fewer specialist referrals and fewer traditional “team” relationships.

The most logical course of action for a specialist considering the trends is to develop a short term (12-36 month) action plan on how they will adapt to these trends. For those who want to thrive and enjoy their special status in the profession as specialists, dental specialist marketing focused on cultivating and growing a core group of referrers, dental specialist marketing going directly to the consumer, or a combination of both are the avenues to success.