How to Develop and Scale Transformational Technology - My Story

Not of company the people everyone benefits have - is cut out to be an entrepreneur. Lots grand ideas about owning their own of being their own boss and reaping that can come from that. But, for every person that has an idea and dream, many more will never actually pursue that dream. That said, the dental field is exceptionally entrepreneurial. With hundreds of thousands of dental entrepreneurs worldwide, I doubt there is another industry that is quite as concentrated with owner-operators and the multitude of companies and entrepreneurs who support them.

While it takes tremendous fortitude and hard work to open a practice and follow a well-traveled path of attracting patients and profitably providing excellent care, the vision that I had when I founded Alta Smiles would require a much different, and, dare I say, more complex approach. My goal was and remains to transform the orthodontic industry in a way to make highquality orthodontic care accessible, affordable, and convenient for everyone. While I am not a clinician, I am a lifelong entrepreneur and the son of an orthodontist. I have been in and around the industry my whole life. What I saw was an industry that was innovating slowly. Some new technologies were being adopted, but overall, the industry still needed to meet the real needs and desires of patients and their providers. Our research showed that patients wanted greater convenience and discretion in their

treatment options, whether those options were fixed appliances (traditional or ceramic braces or clear orthodontic aligners). Both general dentists and orthodontists want to provide highly consistent, reliable results with a high degree of patient satisfaction, all delivered profitably with as few hassles as possible. I was convinced that through proprietary technology, we could meet the needs of both patients and doctors in never-before-imagined ways. So, while we saw a massive opportunity, we also saw the many challenges we would face. Below I will shed some light on how Alta Smiles is building a company that is poised and committed to transforming the industry with our C5 Hidden Orthodontics solution.

As CEO of Alta Smiles, the job description I created for myself and posted next to my desk reads:

• Establish a strategic vision
• Assemble a team with the right people in the right seats
• Focus on the corporate culture
• Align (no pun intended) priorities
• Ensure adequate resources (financial and otherwise)
• Create a corporate rhythm (meetings and tasks/processes functions)
• Assure execution
• Manage risks

From a technological perspective, we are embracing the inexorable trends in orthodontics - digital treatment planning, remotely monitoring patients to cut down on chair time, and making custom appliances for every patient.

new While each element of my job description is critically important,

ones. Of course, we had to make plenty of customizations this article will delve into what I believe are the three key eleto meet our needs, and we will continue to invest in our customments of our success - both in the short and long term. They

ized solutions. Still, my advice to any would-be entrepreneur is are: 1) advancing technology that provides the company with a

to focus your resources (both time and money) on your critical truly differentiated product/service, 2) creating a highly scalable

needs and outsource to other technology partners where it makes business model, and, 3) ensuring that we create an intellectual

sense. property moat that can be protected.

Our technology solution is much more than just what software From a technological perspective, we are embracing the inexowe buy, build, or customize. Since we have fundamentally rable trends in orthodontics - digital treatment planning,

that goes into making that successful. Our system of placing making custom appliances for every patient. But we are not just

orthodontic wires directly on the lingual surface of the patient’s bundling a myriad of off-the-shelf solutions and calling that

teeth requires us to understand how the specific forces applied innovation. Our solutions utilize digital planning and applito specific teeth in specific locations will affect the movements. ance innovations, but what makes C5 Hidden Orthodontics

So, we had to learn to analyze and optimize those forces without truly amazing is that we can straighten teeth without brackets

putting unhealthy pressure on the teeth. This necessitated or aligners. During treatment, nobody can see that a patient

engaging a cadre of external material scientists, engineers, and is having their teeth straightened, and it’s totally comfortable.

technologists to help us create our solutions. I am a big believer Patients love our treatments, and many clinicians have described

in supplementing internal resources with outside consultants and what we are doing as the “holy grail of orthodontics.” That’s some

experts and engaging them to work in a collaborative environpretty amazing praise! With so many technologies out there and

ment to achieve the desired outcomes. In addition to leveraging being a start-up with limited resources, how does one choose

internal resources much faster, this approach also has the added what technologies to buy and which to “build”? We have cerbenefit of taking the politics out of research and development tainly used both approaches. For instance, there are many digital

efforts wherein internal development folks feel threatened by treatment planning software packages out there, so we were not

“outsiders.” about to recreate the wheel. Instead, we looked at and evaluated existing solutions, adapted and customized them to our needs,

So, now that we have created a better solution, how do we make and then created our own protocols. We took a similar approach

sure our solution is scalable? We are big believers in training and to provider software so that we could seamlessly communicate

documentation. That applies to what we do internally, but it also with our providers. Others had spent years fine-tuning their

applies to the clinicians and their staff who are providing the software solutions to make them scalable and well-supported,

services. To that end, we have invested heavily in envisioning so we started by using 3rd party software rather than building

and executing training materials that are straightforward, interesting, and easy to learn. We have created training materials covering everything you can imagine. The materials utilize the full spectrum of mediums, including animations, videos, and printed materials. We have invested heavily in animation materials, in particular, as we believe they make it easier to understand and visualize what’s going on in the patient’s mouth. We also have created learning systems that are fully available online and tailored them to the specific audience(s). We believe that making this investment upfront will pay longterm dividends in ensuring that we can teach our systems in a highly scalable manner to anyone, anywhere.

The final element that I want to touch on is our obsession with protecting our intellectual property. As I have founded and operated 7 companies throughout my career, I have learned a lot about competition. One lesson that I have learned is that well-established companies don’t like to see upstarts succeed, particularly when they take market share from them. And these well capitalize competitors are all too willing to “emulate” solutions from others. So, it’s great to be nimble and innovative and to have amazing customer service, but it’s even better to have truly defensible intellectual property (patents) that create long-term competitive advantages. From day one, we have been protecting our innovations. To date, we have filed for and/or acquired over 25 patents. That includes key patents in countries all over the globe, as we intend to be a global company. We have also extensively researched other companies’ patents to ensure that we are not infringing the IP of other companies. I have been through and ultimately prevailed in patent litigation in my prior companies, but it is a distraction (and expense) that is best avoided.

Every day I hop out of bed excited by the possibilities of this company and the market-changing solutions we are pioneering. By understanding my role as CEO and engaging experienced, talented, and passionate individuals who share our vision, we are more optimistic than ever that we will continue on our path to success. Focusing on innovation, protecting it, and ensuring that our company can scale is a critical part of our strategy.

As the President, CEO, and Co-founder of Alta Smiles, Gary Giegerich has had a successful 30+ year career as a serial entrepreneur. His belief that a higher level of world-class orthodontic care was achievable through an improved care delivery model and innovative technology is what drove him to found the company. Prior to founding Alta Smiles, Gary also founded and grew five other multi-million-dollar companies covering the fields of technology development and consulting, consumer products design and manufacturing, promotional products, and retail. Gary is a graduate of the Wharton School of the University of Pennsylvania, where he received a Bachelor of Science in Economics. He also has served as President of the Entrepreneur’s Organization Philadelphia Chapter.

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Launchpad From Clear Aligners to Content Creation - How Dr. Avi Patel is Shaking Up the Dental Industry

Luke Shapiro, DDS

Dr. pleted and Northeast Avi worked Patel dental and grew at school then a up in at handful moved Jacksonville, Florida, comNYU, graduated in 2018, of associateships in the down to Austin, Texas, during the pandemic in 2020. Last year he created an aligner course for general dentists, and you can find him on Instagram as @Doctor.Avi - the Clear Aligner Advisor - or on his website www.clearaligneradvisor.co

So I started posting last year in 2022, and I was posting because, at the time, I was doing one-on-one consulting with other general dentists, and I was just teaching them how to do aligners. This was pre-course, literally just working with docs, trying to teach them everything from A to Z.

The docs were paying for the consulting. Even before that, I was just helping doctors in the practice I worked at. Then I wanted an official position, but the DSO that I was at didn’t want to create that position. They just wanted me to focus on producing. So then, on the side, my wife gave me the idea to start consulting, and I was just like, what’s consulting? How do you do that? She helped me because she has a finance background. And then I was just doing cold outreach to doctors in Austin for the consulting business. Then I used social media as a free way to just market for the consulting business. So that’s why I started posting.

Exactly. And I had time at that point, but I didn’t have money. So I was like, let’s give this social media thing a try.

Honestly, no. I wasn’t even following a lot of dental accounts because I was at such a low point in dentistry early in my career where it was kind of triggering for me, because I was suffering from the whole comparison thing where I’d see people doing amazing dentistry, and I just felt like the work that I was doing wasn’t up to this high standard.

But now that I look back on it, and realize, the people who are putting out these gorgeous veneer cases and stuff like that are because they took years of training and hours of practice to make it happen.

It’s funny because my mom had actually told me to post when I first came out of school. But I just didn’t feel passionate about making content like teaching patients how to brush and floss. Cause that’s all I had seen. And so I was like, that’s not true to me, so I didn’t post anything dental.

I think the fact that one, there’s a need. I think there’s a big gap in just foundational training for general dentists from a general dentist perspective. And then I think about the fact that I’m willing to share a lot of free education. I’m not holding the secrets back. I think it’s a procedure that a lot of GPs don’t know how to do, but are interested in learning how to do it.

But then also I think the general public wants it. Patients want this treatment. I think we’re living in an era where a lot of people in their thirties had braces when they were kids. They didn’t wear retainers - so there is a lot of treatment out there.

So ever since January, 2023, I went down to two days in the office. So Mondays, Tuesdays, and then I spend the rest of the week working on the business. I’m learning a lot about marketing because that is kind of the biggest thing for me to grow the business right now. Over the last year and a half, I’ve made several

modifications and improvements to the course itself, just based on feedback from the doctors in it.

So it was me for the longest time. I just now got an assistant, but I’m working on training her to take some of this stuff off of my plate. A lot of the content was taking up most of my time. So I’m working on creating systems to have her run some of my social media. I mean, it’s still me on my page, but I’m starting to see the power and the value of delegating some things so that I can work on other projects.

I had one guy that I talked to recently, I was actually trying to sponsor his group. He was like, “What makes you qualified to do this? Why would anyone want to learn from you?” And it kind of threw me off, because that was the first time someone has directly asked me that. But it was a fair question. I answered, “I’m qualified to teach people how to start doing this because I just went through this. It’s fresh. I know the challenges. I know the struggles.”

Yeah, like zero clue on how to do it. It teaches people how to start.

I think, me personally, it’s going to be honing in on this niche. I’ve had some doctors ask if there’s more, like a part two. But I think what I would want to do is collaborate with orthodontists or other doctors who have more advanced training. Or create an even more basic version for someone who may not be ready to dive into all this.

It’s funny you’re bringing it up because I was actually thinking the growth with the program has put me in a place where even when I have the three days a week to work on it, I still feel like a

time crunch. So, I’m trying to optimize my time, but I could see myself going down to zero clinical because, for me, I’m seeing other gaps in dentistry that I would love to kind of help fix.

No. So when I first started, I was kind of measuring myself against them. Like, dang, these people already have solid courses. How am I going to be able to compete? But the more that I’ve exposed myself to non-dental entrepreneurs, and some super successful people, I’ve learned about and leaned into an abundance mindset. And at the end of the day, if you are adding value to an area of need, then there is no real competition at that point.

Yeah, I think it’s interesting. So I think I get why those companies exist. I understand what they’re trying to solve, but I still think that the general dentist, if you’re offering aligners in your practice, you need some type of foundational education, because as much as it might be easy to just get a treatment plan and execute it, I’ve been in an office where that was the case and I just saw train wrecks of cases because the doc didn’t know how to do the basic things like IPR or to remove flash around attachments.

It sounds great, but if they don’t know how to do it, it’s going to cause a lot of refinements and wasted time. And it’s because I don’t think the GP actually had that foundational training. So I think you’ve got to have both. But as a GP, you got to know the basics.

Dr. Lucas Shapiro is a graduate of Washington University in St. Louis and Stony Brook University School of Dental Medicine, where he received his Doctor of Dental Surgery. He completed his post-doctoral orthodontic training at Tufts University School of Dental Medicine. He currently practices orthodontics at Lemchen Salzer Ortho in NYC. He started the Instagram page @futuredentists, works with the educational organization @ignitedds, and has an orthodontic tiktok page @drshap.

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Impact Reducing Errors in Dental Operations

Yvonne Simmons Howze, PhD & Zina Berry, DDS

Dentistry and sionals. to the dentists average Dentists is a highly respected healthcare field, are highly-skilled, competent professeem to have it all together, and eye, their offices run smoothly.

These three measures, when used consistently, ensure sustainability, reduce staff burnout rate, and keep patients committed to following through on their treatment plans. These measures can be used to both prove and improve the work that dentists However, unbeknownst to most patients, a dental office has a

do. significant number of daily processes that must be followed to minimize the time a patient spends scheduling an appointment, preparing for their visit, receiving treatment, and paying for the

REDUCING ERROR RATE #1: PATIENT DENTAL RE-WORK service. Thus, this article describes three common clinical and operational errors found in many dental practices, and it makes

Typically, when we think of errors in Dentistry, we first think recommendations for reducing them.

of errors that require re-work. Re-work is waste, and waste within any business can be a costly endeavor. If a dentist must Dental offices can be increasingly more efficient and effective in

re-do a procedure, the Practice and the patient are affected. For reducing errors by analyzing the impact of three critical meaexample, in Figure 2.0, a dentist might consider the following sures of success: accuracy, timeliness, and costs. Figure 1.0 gives

when a patient must return for re-work of a root canal: (see a brief definition of each measure.

Fig. 2.0)

ACCURACY

For two hours of re-work, the following estimated costs might be applicable:

Accuracy Getting it right the first time

Patient Time off work per hour $60.00 Patient travel to/from for 25 miles at $.62 per mile $62.00 Timeliness Delivering the service or product on time

Average Daycare costs $36.00 Dentist and dental assistant re-work $240.00 Costs Reasonable cost of the product or service

Front desk rescheduling $42.00

Figure 1.0 Measures of Success