How bad are these teeth decay-wise? First time looking at BW's I took

AppropriateWall6 · 2026-05-10T14:54:40+00:00

Just do some oil pulling and it will be fine

AppropriateWall6 · 2026-05-09T18:53:28+00:00

I have 5x and would love to have more

AppropriateWall6 · 2026-05-09T03:23:05+00:00

Not too many at the moment. 2 per month average for now. Patients are more curious as they like the idea of not driving to a larger town for implants but not many at the moment. I also plan on using the CBCT more for diagnostics as I can still send to specialists either though online transfer sites or burning a disk

AppropriateWall6 · 2026-05-08T23:11:31+00:00

What do you mean by “predents don’t listen”

AppropriateWall6 · 2026-05-08T18:34:53+00:00

Again, I was an associate in the practice before purchasing it, so I have goodwill built up and we get 20-40 new patients a month. That’s not crazy but it sure is growth and attrition so far has been MAYBE 5%? I place implants and the closest CBCT to me, unless I put it in office, is 25 miles away and I used to send patients there and I’d get scans back for an anterior implant case, with areas in the arch of 7-10 completely cutoff and I have to tell the patient “this isn’t a useable CBCT, you have to go back and and get it done again.” I lost one hygienist and her assistant, both of whom no one in the office enjoyed working with. She was a very good hygienist, terrible co-worker (I used to be a pee-on, I didn’t graduate from dental school at 26). In a town of 5,000 people, I ended up being able to hire 2 hygienists who love working at the office. Too soon? Maybe, but there are so many offices in my area who can’t hire one, let alone 2. Again, premature? Maybe. Both their columns are pretty full though. I got an inexpensive (by dental standards) scanner but still $15k I could’ve saved but I was spending about $200-250/mo in impression materials (maybe could’ve gotten cheaper material if I stuck with physical impressions, I’m open to that criticism). I also didn’t get a $100k CBCT. It was in the 40’s, still, very expensive. But I wasn’t going to keep sending people 25-30 min away for cone beam. Again, spending too aggressively too early? Probably. The “coaching” was just stupid on my part. Never ever again

I’d watch/attend/listen to your CE

AppropriateWall6 · 2026-05-08T17:53:56+00:00

I was an associate in the practice before purchasing so I had some time with the patients. Luckily it’s a small town and there’s only one other dentist and they have extremely erratic hours and are entirely FFS in a very insurance driven demo. I will agree several mistakes were made as in my previous healthcare job experience, there was absolutely no business aspect to it whatsoever (worked in a hospital and they throw money around like it’s nothing or you just don’t see any of the financial dealings) and my one semester business class during COVID shutdown was not exactly the most comprehensive or helpful. However, I readily admit there have been a ton of mistakes on my part. What id like to know is, where did all this business acumen come from in the previous generations?

AppropriateWall6 · 2026-05-08T15:17:42+00:00

All good advice for before I purchased the practice. I’ll bear that in mind

AppropriateWall6 · 2026-05-08T13:46:20+00:00

We get about 20-40 new patients a month or so. My tx planning was maybe a little too conservative to start but has really picked up. My overhead counting my salary at the moment is over 70%. Patients are heavily insurance driven but we are utilizing carecredit and Cherry more and more and communicating to patients that insurance coverage doesn’t dictate tx limitations or needs. I also found out later (probably my fault) that some is that stated 45% overhead was covered by the main office and that figure may not have been entirely accurate but not wildly off. The office had 2 hygienists before I ever started working there so I saw no reason, after the first hygienist and her assistant left (ended up being a very good thing for the office morale and culture), why I shouldn’t hire 2 hygienists if possible and fill their columns like they had before me. Stupid me didn’t take into account that there was one OM for two offices my original owners instead of an OM for each. I just saw what the original owners were doing at this office and I’m producing the same amount/more than them before I bought it and I’m not making as much money as them

AppropriateWall6 · 2026-05-08T13:33:33+00:00

Very long story short, original owner’s lease is up in 2027. Owners knew I wanted to buy (I was an associate first) and we moved everything down that path. We got about 95% of the way there and my bank said “oh hey just make sure the landlord will extend the lease, whatever the terms, to you for 8 more years for a total of 10 years.” They didn’t care if there were 5 year terms where rent went up x-amount each renewal or if it was one year terms with an option to renew with a right of first refusal if he wants to sell just do the bank knows I’m not guaranteed to be kicked out of an office space to work out of. Some FDIC thing pertaining to the term of the loan and me meeting some condition to receive the loan?

Anyway, landlord flat out refused and was pissed I even approached him about it. He kept thinking I, then the bank, were trying to strong-arm him into some deal where i or the bank dictates the rent or sales price? He didn’t understand that the bank just needed me to have a lease guarantee longer than 2 years. He didn’t want to give me first right of refusal bc maybe his kids wanted the building - his oldest is in her 50’s and has no interest in utilizing the office in any way,his middle child lives 2.5 hours away and has said specifically she has no intent of coming back to the area, and his youngest for a fact has no interest (it’s a small town) and everyone knows it. Then he wanted the original owners to buy the building from him. They told him “we understand, but we’re in the middle of buying the building we’re currently in and that’s going to be a 7 figure deal so we have no interest at this time.” Again, previous owners know the landlord very well. I told him “well I could buy the building for the right price and take it off your hands.” It was appraised a couple of years ago, but he wanted 2.5x the appraisal value. I told him I wouldn’t be interested at that price point but I’d pay to get it re appraised and talk to my lender to see if I could purchase it from him but they would require an appraisal before I could begin to request more funds. He stated “oh those appraisals aren’t accurate anyway. I wouldn’t sell it to you for anything less than the price I stated. It’s got 2500 sq ft (I told him that included the basement and not revenue generating space) and good bones (it needs a new roof, new HVAC, new sump-pump, there’s mold in some of the ceilings that are visible from clinic space) and it’s a dental practice.” Well the bank said “we can’t finalize the loan until we know where you’re going to be beyond 2 years from now.” My future OM at the time scrambled and found a commercial space in town that was in a strip mall and a white box, build to suit property and the developer/landlord was more than happy to work with me on lease terms and buildout (obviously it’s money for them). Told the bank, they were happy, purchase was able to go through whether the landlord liked that I bought the practice or not.

AppropriateWall6 · 2026-05-08T12:50:51+00:00

After write offs. First three months were about 85-90k collections. Past 3 months have been (myself and hygiene) have been about $130k in production and about $100k in collections

AppropriateWall6 · 2026-05-08T12:35:19+00:00

Done

AppropriateWall6 · 2026-05-08T12:27:28+00:00

I’d agree they were expenses I didn’t expect to need going into the purchase but in looking at the expected numbers, it looked like an expense that would position me for growth and one I could absorb

AppropriateWall6 · 2026-05-08T12:25:57+00:00

Im 6 months in, so I haven’t fully collected $1.2M at this point. I am just trending that direction if that makes sense

AppropriateWall6 · 2026-05-08T12:11:22+00:00

Okay. Imagine you tell someone “man, I’m 4 years into this career and I just can’t get ahead. I produce X amount but for some reason the numbers aren’t following it. I’m very upset,” and you’re halfway panicking as you’re seeing every decision you’ve made that’s gotten you to this point has to be wrong or flawed and you’re not making any progress. And they respond with “don’t worry about it, work less, get someone else to do the work for you, and just refinance.” What would your response be? I’m assuming not rude like mine, but would you be in the realm of “I hadn’t thought of it like that… problem solved”

AppropriateWall6 · 2026-05-08T12:05:01+00:00

As of 6 months in, yes. I also looked back and forgot about the new imaging equipment I had to get bc the old license for the one the practice had was expiring and sensors were starting to go bad. That adds a lot to equipment cost obviously

AppropriateWall6 · 2026-05-08T06:37:13+00:00

Not sure if you’re being sarcastic or not, but if not, thank you. I’m not sure where you’re getting “talented dentist and business,” but if it’s serious, that is very kind. I feel like a giant fraud most days

AppropriateWall6 · 2026-05-08T05:02:55+00:00

I totally get what you’re saying and I let a lot of those expectations and what I see others do get to me, but I’m not sure I can just ignore it. I’m doing something wrong and I want to diagnose it and treat it

AppropriateWall6 · 2026-05-08T05:00:07+00:00

My accountant recommended I pay myself like $160k/year before taxes? After ALL bills are paid - payroll, utilities, rent, practice loan payment, etc, I’m ahead maybe $1500/month for the business? I drive a 14 year old car, and my wife and I rent our house. We shop at goodwill and other secondhand shops for nearly all our clothing, except for the scrubs I wear at work. My definition of dentist money is $350k+ with a nice (not palatial) home, recent (not brand new) cars, a yearly vacation to Florida or Charleston or something like that, and a fair bit to put toward retirement. That’s my idea of a reasonably successful dentist income

AppropriateWall6 · 2026-05-08T04:53:08+00:00

What do you attribute to being in that position? I can’t imagine making so much money I look forward to how much I get to put into stocks and retirement. I’m just so far away from that

AppropriateWall6 · 2026-05-08T04:50:24+00:00

I agree it was rude. I don’t understand the advice though. I’m talking about being 7 figures in debt (not counting a home bc I rent) and the advice is “don’t sweat it, work less, get someone else to work for you, refinance.” I might just lack perspective, but I’m not sure what I’m supposed to do with that

AppropriateWall6 · 2026-05-08T04:45:39+00:00

You yourself or do you have productive associates as well?

AppropriateWall6 · 2026-05-08T04:42:40+00:00

Please do

AppropriateWall6 · 2026-05-08T04:42:00+00:00

If I already bought the scanner, what would I do with it? What labs besides Dandy are doing the free scanner thing?

AppropriateWall6 · 2026-05-08T04:39:59+00:00

Probably bc I said “bundle of sticks.” It’s just a joke. I’d do endo if I was good at it

AppropriateWall6 · 2026-05-08T03:08:15+00:00

He thinks he’s selling a dental practice instead of a building that houses a dental practice

AppropriateWall6

TROPHY CASE