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Hello. This is Cameron Cortejano with the Becker's

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Dental and DSR review podcast.

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I'm thrilled to be joined today by doctor

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Bradley Dykstra, who is the CEO at MiSmiles

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Dental Group.

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Doctor Dykstra, thank you so much for being

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here today. It's my pleasure, Cameron. Great. To

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just start us off today, can you introduce

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yourself and tell us a little bit about

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your background?

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Yeah. Okay. I'm Bradley Dykstra. I got my

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DDS from the University of Michigan, go blue,

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many,

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many years ago.

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I have not been at the chair for

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five years now,

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but I'm still actively involved in the management

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side of our organization.

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And we're a small

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doctor owned, doctor led

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DSO

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in Western Michigan,

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generally the Greater Grand Rapids, Michigan area,

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which is a great city, and it's becoming

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more and more famous throughout The United States.

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So that's good.

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And, also, several years back, I did go,

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and I did get my

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MBA.

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And as far as our organization,

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again, we do have certain things centralized. Most

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of our RCM is centralized. Our HR is

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centralized.

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Our call center is centralized.

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And, also, we have a cloud based software

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which makes

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keeping tabs on all the doctors and everything

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great, and it allows them to interact even

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from different offices. So that's a little bit

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about who we are.

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Awesome. Thanks so much.

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What are some of the biggest issues

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that you're currently following in the dental industry

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as we're a couple months into 2025.

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So what trends have you kinda seen so

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far, and what are you kinda looking at

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for the rest of the year?

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Okay. Well, a couple things are

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I continue to follow, and that's kind of

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the reimbursements

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rates,

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the

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consolidation

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trend that seems to be continuing.

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And I guess in one sense,

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if it gets too big and some of

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the big DSOs get

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too big, I just

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that concerns me that they may have too

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much influence

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in the whole dental world. But I think

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we're a long ways from that, but that

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is a concern.

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I'm following also a lot of the states

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are adding more reciprocity

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between dentists. I think that's a good thing.

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The other issues that I'm following is I

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know there's talk of increasing hygiene capacity. They

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are putting up new dental schools to produce

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more dentists,

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which we direly need.

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And I think the other issue I think

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that's just definitely

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in the last couple months is

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the consumer

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confidence

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in our country seems to be taking a

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hit.

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And so I'm sort of watching that. We

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have not seen an effect on patient flow

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or treatment acceptance yet,

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but that is something we're really paying close,

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close attention to.

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And as always, again, with reimbursements

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not going up to with the cost of

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labor and all of our other costs,

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the profit squeeze is something we have to

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not forget about.

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Yeah. Absolutely.

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So when you talk about this consolidation,

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continuance of that in the DSO space

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and and, you know, the big DSOs and

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big groups getting bigger,

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what do you kinda see for maybe, like,

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a timeline of, like, how these big DSOs

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will really

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set themselves apart in just terms of sheer

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size from from some of the other practices

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and

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kind of what you might think could cause

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that continued consolidation

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going forward?

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I think when, you know, when they get

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a certain size, I think they are able

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to

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provide,

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I'll say, better learning opportunities

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for the dentist,

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maybe have more structured program, just programs because

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of their size.

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And and, again, I'm not saying they're there

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now. And I think with

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the current economic environment,

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I don't see

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any huge mega mergers

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on the horizon.

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But it's just something that it's kind of

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out there. It may or may not happen.

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So I do not have a crystal ball,

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Cameron, but,

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I mean, I like the fact

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okay. We're a small group, dentist owned, dentist

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led,

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and so we can still keep the the

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family atmosphere,

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everything else, you know, sort of like the

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independent

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family practice,

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except we have

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a little bit of size, which does

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allow us to centralize a few things, get

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some cost savings in certain areas.

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But, again, not the cost savings that the

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really big ones can get. And, again, that

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puts everybody else at a little bit disadvantage.

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But

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that that that's the American way in capitalism,

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so

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we just have to be aware of it

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and pick our pick our lane.

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Right. That makes a lot of sense.

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Something that I'm curious to get your thoughts

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about are what are some things that you're

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most excited about when it comes to dentistry

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right now, and what are some things that

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are potentially

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making you nervous about the industry?

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Well, there's

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technology has always been

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on my front burner for all of these

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years, which has really kept me involved and

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interested in dentistry.

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I've had the opportunity

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in

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earlier years to be really instrumental in speaking

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on digital radiography, intraoral photography,

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scanners, lasers, all that good stuff.

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But right now, it's all in

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AI. I mean, just

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in addition

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to what AI can do in the treatment

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room,

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that's just really, really

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awesome that we happen to use Pearl. I

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don't know if we're supposed to use trade

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names or not, but we use Pearl with

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our CareStack, and it works really, really well.

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So that is great. But what I'm really

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what we're

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looking at now and we're hoping it arrives

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sooner than later

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is instead of having just chatbots that we

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can use for certain things,

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but more into the real virtual agents that

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can really answer the phone and do a

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lot of things that will free up our

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team members to spend time with what only

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real people can do, which is relating to

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the people in the office,

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servicing them, and doing their treatment.

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So,

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you know, virtual agents, and the other is

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basically

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RCM automation.

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With the technology available today, there's no reason

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that things have to be as complex as

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they are.

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So I'm looking for this year. I'm really

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excited

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because I think we'll see a lot of

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advances

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in the next

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nine to twelve months in in that whole

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area.

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So that's really what I'm excited about. And,

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also,

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you know, something we started using last year,

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and that's Securonaut. It's a way

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if there's incipient

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curious lesions instead of, well, we'll watch it,

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and if it gets bigger, we'll treat it.

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Now we have a positive step we can

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take

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and not always, but many times to arrest

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or reverse

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the demineralization,

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which really then

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gives a patient a good service.

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So instead of we have an option other

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than just watching. We actually have something positive

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we can do. So I I've I'm really

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positive about that. And I think in the

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whole area of periodontal disease,

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I do believe there's

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a few things happening in that arena that

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I think will make our

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our job more

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patient

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specific as opposed to just

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everybody the same.

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So that's kind of what I'm excited about.

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I'm not sure anything makes me nervous at

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this point. It's more things

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like we talked about issues that we're following

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or that we're monitoring.

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But one is the aging of the dental

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workforce. I mean, many of the hygienists have

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already retired in the next five or six

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years. Probably a lot more will.

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And the same with dentists. There's

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a lot of dentists that are

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just retiring or thinking of it in the

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next couple years.

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And the young ones,

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there aren't quite enough of them to take

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everyone's place yet. So that's the other thing.

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And

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the other thing that's

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big unknown again right now is

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what are the effects of the potential tariffs

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on

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our costs of

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supplies, materials, equipment?

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And

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so that that whole area and, again, that

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ties in with the consumer confidence going down.

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So I think the tariffs and consumer confidence

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maybe is

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thing I'm concerned about the most.

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And, also,

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you know, the the power the insurance companies

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seem to have yet,

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I guess,

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that that's not a positive in my book.

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I know there are a few inroads starting

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to to help the dental world out in

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that regard, but we've got a long ways

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to go.

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Got it.

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When it comes to those shortages of of

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dentists and hygienists,

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is it mainly just due to, you know,

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less

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graduates from dental and dental hygiene programs, or,

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is there maybe something else behind it?

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I would say it's multifactorial.

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COVID had an initial

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effect that we haven't fully recovered from yet.

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And I think especially in the hygiene world,

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I think it's

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not so cost effective

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for institutions

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to

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educate dental hygienists.

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And

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even if they wanted to increase their enrollment

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enrollment, they would need more instructors, which are

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in short supply. So

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I'm not sure all of the reasons.

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And and the other thing that we've noticed

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in the in the hygiene world, and

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we're not sitting too bad. We have

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most most of the number of hygienists we

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need, but we do use

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basically subs

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probably

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every day in a few of our offices.

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And we're finding a lot of the hygienists

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now, they like to just

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kinda sub go from office to office so

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they're they can work if they want, not

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if they want. So it gives them real

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flexibility.

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They tend to charge quite a bit. So,

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you know, that is what it is,

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but I don't have the specific answer. All

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I have is some vague ideas.

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Got it. Thanks.

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And then just the last question

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that we have today. In your opinion, what

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will the most effective health care leaders need

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in order to be successful in the next

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two to three years?

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A few things. Number one,

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don't panic no matter what's going on you.

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Remain calm.

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Stay in your bubble, we would call it.

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If there's something outside of your control,

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don't worry about it. Only focus on things

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in your control.

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And, again, no matter what happens,

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keep your ultimate vision in front of you

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and in front of the team so we

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know why we're doing what we do.

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And, again, stick to your core values when

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you're making your decisions. Whatever you do, if

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you have your core values,

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stick to them,

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and

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don't waiver just because of

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certain economic conditions at any given time.

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And as always,

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really pay attention to

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the culture in your office and

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really understand your numbers, understand your KPIs,

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and

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delegate everything that you possibly

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can

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effectively.

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That does doesn't mean just give it to

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somebody, but

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help them learn it, do it, inspect what

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you expect,

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and really use

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KPIs,

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use numbers,

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understand your numbers, and pay attention to them

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and use them. Because if you don't, you'll

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get

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you won't be successful.

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Awesome. Thanks. Yeah. I think those are some

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great things, for for leaders to keep in

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mind,

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going forward, especially with some uncertainty

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in the dental space at least.

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So thanks

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a lot. Really appreciate those those thoughts.

365
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Well, you're so welcome, Cameron.

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Well, thank you for joining us today, doctor

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Dykstra, and sharing your valuable expertise and insights

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into the dental space and in the industry.

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It's been a pleasure speaking with you, and

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I look forward to connecting with you again

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in the future. Alright. I'll look forward to

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it too, and you have a great day.

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Thanks. You too.