By Dr. Richard Wolfert, DMD  

The Toothboss,

Slowly, Dental Service Organizations, or DSOs, are pushing out the traditional dental practices. And it’s hitting all consumers where it hurts the most – the wallet.

What’s a DSO?

DSOs are essentially private equity firms that saw the profit in dentistry (and medicine in general) and started buying up practices and running them. Their business model is simple. These organizations offer employment to doctors and dentists who no longer want to be involved in the business side of running a practice. In running these practices as businesses, DSOs are making changes that we all feel.

What DSOs are changing

The impacts of the DSO system, for both dental practices and medical practices, can be seen everywhere and include:

• Overbooking clinicians to their wits’ end as more and more patients are pushed at them

• Less time for the physician or dental practitioner with patients.

• Longer and longer wait times to see the doctor; sometimes more than an hour.

• Treatment being diagnosed may not be needed at the time simply to make sure the “company” reaches monthly production goals.

• Doctors and dentists, many of them on the younger side, paid based on the number of patients seen and the high value procedures recommended. And they feel compelled to do so not only to maintain their position, but to pay off the massive school debt they have incurred after so many years of education.

Suffice it to say, I’m not very happy with the way healthcare is heading. And as someone who has been a practicing dentist for the past 40 years – both in private practice and the military – I hate to admit it, but I’m part of the system.

The bright side

Unfortunately, the DSO system/model has overshadowed a number of advances in medicine and dentistry. In my area of medicine, I have seen the era of digital radiology expand to the point where there are very few clinicians now who use regular film that requires a darkroom and chemicals to realize an image.

We have also seen the growth of what’s called cone beam technology. Instead of the two dimensional radiographs we had been using for years, dentists now have the capability of seeing a three-dimensional image of the jaws and teeth.

For a missing tooth, dentists have the option of dental implant rather than the conventional non-removable bridge that was our only option 30 years ago (that particular treatment invariably put other teeth at risk for more treatment down the road).

We have seen the advent of tooth-colored composite restoration so we can make a tooth look like a tooth rather than have silver metal fillings replacing missing tooth structure. And we have seen the development of caps that look more like teeth than they ever have before with the development of a tooth colored metal called Alumina.

What is my advice?

Be wary of healthcare. Question the provider to make sure you understand what and why they are doing a procedure.

Make sure you know if there are any out-of-pocket expenses so you are not surprised if you are billed. And know how much you are going to owe.

Be your own advocate, and if you’re not getting the answers that sound right to you, move on to another clinician.

I personally went through four urologists before finding one I trusted was doing procedures in my best interest, not theirs. Was I totally convinced that this fifth one was? Not completely. But this particular provider spent time with me and explained the reasoning behind his recommendations and acknowledged he understood where I was coming from. At that point, I trusted him.

And sometimes that’s what it comes down to – trust.

We here at The Toothboss have a traditional practice and spend the time necessary for our patients to trust us. If that’s what you’re looking for, we are here to serve you.

About the Author: Dr. Richard Wolfert, DMD is the owner of The Toothboss, 1121 Main St., South Weymouth. For more information, call 781-335-0604 or visit