Oral Cancer Awareness Month

Did you know April is Oral Cancer Awareness month? About 53,000 people will be diagnosed with oral cancer and nearly 10,860 people die annually. It is twice as common in men as women. Oral cancer can affect any part of the oral cavity. Which is the lip, tongue, mouth, and throat. Through visual inspection, your dentist can detect abnormalities at an early stage resulting in less extensive and more successful treatment.

5 Myths and The Actual Facts

  1. Oral Cancer is rare.

Fact: More people are diagnosed with oral cancer than stomach cancer.

  1. I’m too young to get oral cancer.

Fact: It’s now more common for our younger patients to develop oral cancer because of the link to human papillomavirus (HPV.)

  1. I don’t smoke so I can’t get oral cancer.

Fact: Smoking does increase your risk for oral cancer but it isn’t the only factor. Drinking alcohol, HPV, and genetics play a role in developing the disease.

  1. No pain, no problem.

Fact: Not all cancer spots can cause pain.

  1. I will know when I have oral cancer.

Fact: It’s not easy to identify, it can go undetected in your tonsils, lymph nodes, and the base of your tongue.

Causes

The exact cause of oral cancer is unknown, but here are some things that can put people more at risk.

  • Tobacco of any form – cigarettes/ e-cigarettes, cigars, pipes, and smokeless tobacco.
  • Alcohol
  • Excessive sun exposure on your lips
  • Human papillomavirus (HPV)
  • Weakened immune system

Signs and Symptoms or Oral Cancer

  • Mouth sore that doesn’t heal
  • White or red patches in your mouth
  • Chronic sore throat
  • Difficulty swallowing or chewing and moving the jaw and tongue
  • Jaw swelling
  • Lump in the neck
  • Constant bad breathcta 3.png

A lot of these signs and symptoms can be caused by other things, schedule an appointment if any of these conditions go on for more than two weeks.

Prevention

Stop using tobacco or don’t start. It exposes the cells in your mouth to dangerous cancer-causing chemicals. Drink alcohol in moderation. Excessive alcohol can aggravate cells and make them more susceptible to cancer.

Protect your lips from the sun! Constant exposure increases the risk of cancer. Be sure to use lip balm with SPF!

Last but not least, see your dentist regularly! It’s recommended to have an exam and cleaning every six months. Schedule yours today!

ADS South, LLC 
120 Istoria Drive
St. Augustine, FL 32095

Phone: (770) 664-1982

ADS South:

Since 1984, ADS South has served practice transition, apprasial, associateship services, pre-retirement transition support and expert testimony needs. ADS is known by its impeccable reputation as being fair, honest and effective in helping dentists plan and implement their transition strategies.

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Show Love to Your Oral Health

Whether you choose to deny it or not, it’s the month of love. February is American Heart Month. Did you know there’s a connection between your heart and oral health? If you plan on stuffing yourself with a ton of sweets, you should be careful! Your teeth need love as well, don’t forget about them.

Yes, it’s true, gum disease increases your risk for heart disease. Lack of care for your teeth and gums can lead to gum disease. If it’s not treated, plaque and bacteria can make its way to your bloodstream and travel through your body to your heart which can lead to blood clots or possibly heart attacks.

Tips For Healthy Living

Valentine’s day – Date night, some people might say they go hand-in-hand. But If you don’t think so, use this tip for whenever you go out and eat.

  • Keep some floss in your bag or pocket. The quicker you get rid of the food particles and bacteria the better! Also, water is the best drink for your teeth, it rinses away acids from your teeth. Pro Tip: order water with your meals.
  • Dark chocolate is actually good for your teeth! Well, in moderation of course. It contains less sugar than milk chocolate and can help with preventing cavities and tooth decay. Chocolates that have a chewy sugary center will more likely cling to your teeth. Yes, you might like those better, just try to eat a couple rather than the whole box.Candy
  • Gummy candy, you want to try to avoid those! They are the worst candy for your teeth. The bacteria in your mouth set off a chemical reaction that turns the sugar into an acidic form then it eats away at the enamel of your teeth. This is known as demineralization. Also, gummy candy sticks to your teeth. When you think about saliva you might be grossed out but when it comes to your mouth, it’s a good thing. It neutralizes acids that come from sugars and protects your teeth.

Alternatives to gummy candy: Xylitol is a sugar replacement that bacteria won’t recognize and doesn’t attack and turn it into acid like they do with sugars. Save your teeth from an attack and read the ingredients!

It’s always a good time for sweets! – WRONG. For some of us, we can’t say no to candy. Eat them after a meal to limit the exposure of sugar and bacteria! Be sure to wash them down with water.

Love is in the air! Did you know that kissing helps prevents cavities? It stimulates saliva and breaks down plaque to get rid of bacteria.

Love Your Teeth

  • Brush twice daily
  • Floss daily
  • Schedule bi-annual teeth cleanings

Those are the basics! Here are a few changes that might benefit you:Brush.png

  • New toothbrush – your toothbrush should be replaced every 3 months! Use soft bristles, don’t be rough with your gums and teeth.
  • New floss? There a bunch of floss out there, don’t be afraid to try something new! Or if you are new to flossing try something and fall in love with how it makes your mouth feel!
  • Toothpaste – Are you loyal to a certain brand? If you can never settle on a certain brand, look for one with an ADA seal! They help remove the plaque from your teeth and protect them from decay and gum disease.
  • Time – sleep in too long or too tired at night to brush your teeth? It’s recommended to brush your teeth for two minutes. Make this change, your mouth and dentist will love you for it! Use a timer while brushing or play your favorite song! It’ll make the time fly by.

Are you wondering if this check-list applies to you if you have dental implants? The answer is: YES, they feel and function like your natural teeth. Which means there shouldn’t be a change in your dental routine.

Treat your heart how it deserves to be treated! Limit your sugar intake, walk or take the stairs rather than the elevator, and take care of your teeth and gums.

ADS South, LLC 
120 Istoria Drive
St. Augustine, FL 32095

Phone: (770) 664-1982

ADS South:

Since 1984, ADS South has served practice transition, apprasial, associateship services, pre-retirement transition support and expert testimony needs. ADS is known by its impeccable reputation as being fair, honest and effective in helping dentists plan and implement their transition strategies.

 

Be A breath Of Fresh Air This Holiday Season

It’s the season to get together! Do you always avoid one family member because their breath stinks? Or do people avoid you? Either way, nobody wants to be “that” person at gatherings. As time goes on, people don’t forget who the culprit is. Don’t let it be you!

Typically, we all wake up with bad breath because there is no constant saliva flow as we sleep. Saliva helps wash away bacteria growth. A reminder to why we brush and floss before we go to bed and when we wake up.

Did you know that over 40 million people in the U.S have bad breath? Most of the time you aren’t able to smell your own breath! Because of the embarrassment, often times we don’t mention it when we smell others breath.

What is Bad Breath?

It’s your oral bacteria which are living, eating, and breeding organisms. You know how all living things need food and needs to dispose of it? That’s what is happening in your mouth! Use this as motivation to start a better dental routine!

What Causes Bad Breath?

  • Smoking and Chewing Tobacco
  • Poor Dental Hygiene
  • Dry Mouth
  • Diet

BrushThe worst cause is smoking because it reduces saliva flow. Dry mouth occurs when your mouth doesn’t produce enough saliva. It is your mouth’s natural defense and without out it plaque and bacteria build up faster. Certain drinks like alcohol and coffee dry your mouth out as well. Sugary foods and drinks are bacteria’s favorite, it helps them grow/multiple faster. It’s important to brush and floss to help prevent plaque build-up.

You might want to keep a closer eye on your tongue as well. Your tongue doesn’t have a smooth surface; food debris, bacteria, and dead cells can be trapped there. Overtime, a coating forms across and as it gets thicker, your odor becomes stronger.

This year, don’t be the one with the breath that clears a room! Have a solid oral hygiene routine, a good one that includes dental cleanings every six months! If you are stuck on what to bring for your gathering try peppermint bark. It’s a nice breath refresher for anyone that needs it!

Pro Tip: Use dark chocolate chips – it’s good for your teeth (in moderation)!

If you are questioning, “How in the world is dark chocolate good for my teeth?” The answer is dark chocolate contains polyphenols which helps fight the growth of bacteria in your mouth, reducing risk of tooth decay. It can also offset bad breath!

Have a great holiday season!

ADS South, LLC 
120 Istoria Drive
St. Augustine, FL 32095

Phone: (770) 664-1982

ADS South:

Since 1984, ADS South has served practice transition, apprasial, associateship services, pre-retirement transition support and expert testimony needs. ADS is known by its impeccable reputation as being fair, honest and effective in helping dentists plan and implement their transition strategies.

It Doesn’t Get Easier, You Just Get Stronger

Okay, so not all profound quotes have a distinguished author, but they can still be profound. I saw this one on a T shirt on an attractive woman on the beach at the Dominican Republic and was glad I took the time to read it. For several reasons. Watching my wife’s efforts of working on her instrument pilot rating has been a prime example. This has been a year-long project that has been as hard as getting a PhD degree. Not only does one have to learn all matter of physics, meteorology, navigation, rules, regulations, the language of talking to controllers, higher mathematics, and interpreting charts, one also has to have the physical and mental skill to be able to put an airplane through its paces for a successful and safe flight. I saw her frustration when she began this project. She was totally overwhelmed by her abject ignorance of all of those elements, with self-doubt that she would ever be able to have the faintest understanding of any of it.ADS Blog.png

But with an enormous conviction to study, understanding, and practice, her mastery of the project slowly began to develop. At times it has been very frustrating, but she has doggedly pursued her studies and flying, and her mastery of this project has been absolutely astounding. She is proof that nothing gets easier, but if we’re smart and resourceful, persistent and apply ourselves fully, we do get stronger – incredibly stronger – allowing us to prevail in our goals, whatever they be.

ADS South, LLC 
120 Istoria Drive
St. Augustine, FL 32095

Phone: (770) 664-1982

ADS South:

Since 1984, ADS South has served practice transition, apprasial, associateship services, pre-retirement transition support and expert testimony needs. ADS is known by its impeccable reputation as being fair, honest and effective in helping dentists plan and implement their transition strategies.

 

What Causes Bad Breath?

We’ve probably all known someone with bad breath. It can be uncomfortable to engage in discussion with someone whose breath smells downright foul. It’s also a sensitive topic to broach, as well as being a very common concern – after all, each year Americans spend an estimated $3 billion dollars on breath freshening products. Halitosis, more commonly known as bad breath, is clearly a concern well felt amongst adults – but what is the cause?

Symptoms and Sources of Bad Breath

There are several sources of bad breath, including diet and dry mouth – both boil down to the presence of bacteria. The most common odor-causing bacteria are located on the tongue, particularly toward the back where they tend to be undisturbed. If neglected during cleaning, it’s a prime breeding ground for bacteria to feed on leftover food particles, dead skin cells, and mucus. In addition to the tongue, less common offenders include build-up between the teeth and below the gum line, increasing the bad odor. In addition to inconsistent oral care, there are other common reasons for mild cases of bad breath.

Most of us are familiar with the term ‘morning breath’ – a common reference to oral odor experienced in the early hours after waking up. Morning breath can be attributed to a dry mouth, as the result of inactivity during the night fueling bacteria production. Saliva is a natural defense against these offenders, and saliva production slows down the longer the mouth is inactive. If you suffer from chronic dry mouth, the same principles apply whether it’s morning or not. Additionally, food particles (especially sugars) remaining in the mouth encourage bacteria growth. All of this adds up to an increasingly unpleasant and embarrassing odor when you are speaking and breathing.

How to Get Rid of Bad Breath

When it comes to solutions, anything not addressing the presence of bacteria is a purely cosmetic fix. This includes gum, mints, and similar – sorry! The solutions very much depend on the specific source, and may be as easy as improving your general oral hygiene routine, or it could require a deep cleaning by a dental professional. A more serious cause, and subsequent solution, may be decay present in the mouth that requires removal. No matter the case, vigilant oral care will always be helpful in terms of avoiding unpleasant breath!

Bad breath, while harmless, can be an indicator your oral care habits are insufficient. If you are concerned about your breath, try brushing and flossing more thoroughly to remove any lingering bacteria. If the problem persists, contact your dentist for a proper diagnosis and treatment plan!

ADS South, LLC
120 Istoria Drive
St. Augustine, FL 32095

Phone: (770) 664-1982

ADS South:

Since 1984, ADS South has served practice transition, apprasial, associateship services, pre-retirement transition support and expert testimony needs. ADS is known by its impeccable reputation as being fair, honest and effective in helping dentists plan and implement their transition strategies.

Transitioning To Retirement

As we baby boomers work our way toward retirement, we need to consider how best to accomplish this final stage of our careers. Most of us have made some mistakes along the way, but we were able to repair most, if any, damage. However, in this last career step, we need to nail it the first time. There is no reset button. We won’t be able to repair the damage.

In preparing for retirement, it is critical to work past the transition myths that have been floating around the profession for years, and to learn some of the principles that transition experts have discovered. Consider the myth: “If you’re thinking about retiring, october-2016-6bring in an associate so you’ll have a built-in buyer when you want to retire.” I have seen too many disappointed owners who tried this tactic, only to find out that it seldom works.

When thinking about retirement, we need to understand how dentists are wired. Consider these fundamentals. Associates work for other dentists; they don’t buy practices. Buyers buy practices; they do not work for other dentists. If a dentist is wired up to be an associate, he or she is not likely to become a buyer in the near future. When a dentist hires an associate, the owner should not expect that associate to become a buyer when the owner snaps his or her fingers and decides to retire. If the associate does buy the practice, that’s fine, but I would not structure a retirement plan that depends on that happening. When you want to sell a practice, search for a buyer, not an associate.

When should you consider adding an associate to your practice? The single criteria for adding an associate is that there is more work than the owner is able or willing to perform – not because you’re thinking about selling your practice. If the dentist’s (not hygienist’s) schedule is booked for three weeks or more, there is likely adequate work to add an associate. If the owner refers out treatment regimes that a qualified associate could perform, that indicates potential production an associate could treat. If an owner wants to reduce his or her schedule, that would contribute further opportunity for associate production. If you cannot demonstrate enough production for an associate to be busy, you should not add one. Few things are more disruptive to a practice – to the owner, patients, and staff – than adding an associate who does not have enough work to support him/herself, only to have that associate leave.

The owner should have a reasonable pro forma of the financial outcome of adding an associate. Both the owner and the associate need to have a realistic outlook as to what to expect financially before entering into any arrangement. We do not start instrumenting a root canal without first measuring the root. Similarly, the same principle should apply to measuring the financial outcome of adding an associate.

I always strongly recommend that a contract be in place before the associate starts to practice. Too many times, it isn’t. After an associate starts working in a practice is not a good time to begin negotiating the terms of such an agreement for either party.

In states where a covenant not to compete is enforceable, I strongly recommend including that element. Without a covenant, the production an associate performs belongs to the associate, not the practice owner. I will typically give an initial period of 90 days from the start of the agreement until the covenant begins, since an associate is extremely unlikely to be able to harm a practice during such a short term. If the arrangement doesn’t live up to expectations, then the associate is not punished in the process.

Covenants can also be drawn on a graduated basis over a period of several years, starting with a shorter distance and time, and then advancing over a three-year period as the associate becomes more involved with the patients and practice.

Another term that should be carefully crafted in the agreement is the right of first refusal to purchase the practice. If the associate is given a traditional right of first refusal, he or she is able to match any offer from any other prospect who ever makes an offer. The problem with this kind of right of first refusal is that few buyer prospects will want to spend the time, money, and effort on due diligence to generate an offer if they know that someone else can take their offer and step in front of them. This type of right of first refusal can be a poison pill for a seller.

I propose an approach whereby the practice is appraised before the associate begins to work in the practice. This can help determine the financial outlook for owner profitability and associate income, and it also shows the associate what kind of pricing structure to expect in the future when the owner decides to sell the practice. If the dental associate doesn’t think that the pricing structure is fair, he or she may not want to enter into the arrangement to begin with.

At the point when the owner wishes to sell, the associate would be given an updated appraisal price and 30 days to decide if he or she wants to purchase at that price. If the answer is yes, the practice sale is completed. If the answer is no, the owner can then sell the practice to any other party at any other price without the associate having the right to come before another purchaser prospect.

I don’t advise giving an associate the option to purchase the practice unless the owner is absolutely sure that at any point in time he or she is financially and emotionally ready instantly to step aside. An option to purchase is different from the right of first refusal. In the right of first refusal, the seller gets to decide when he or she wants to sell the practice. In the option to purchase, the timing of the sale can be determined by the associate.

I strongly advise paying associates on a percentage commission. That is the only compensation method that will always be exactly right. A fixed salary will likely be the wrong amount, and someone will end up unhappy. A commission gives an incentive for associates and rewards them for going above and beyond. It is helpful to offer an advance draw on the commission to help the associate earn a living during the initial two months of entering the practice.

Carefully consider the termination terms. Will there be a covenant if the associate terminates with cause or if the owner terminates without cause? The minimum contract term and how much termination notice shall be given are issues that should be settled in advance. Document issues such as how re-treatment will be handled as well.

Owners should consider an insurance funded buy/sell agreement in the event of their death. A properly crafted buy/sell agreement can instantly solve what could become a very disastrous situation.

Owners can advertise for associates in many venues. Printed media, such as this periodical, reach a wide circulation. There are also many Web sites that owners can use to search for associates. Many transition consultants also offer associate searches and can screen applicants for the owner as well as suggest transition attorneys who can provide effective legal agreements.

If associateships are not researched, structured, or documented properly, they can create difficult problems from the outset, especially when an owner decides to sell. However, carefully documented and structured associateships can provide an owner with freedom, profitability, and security that is otherwise unattainable.

by Earl M. Douglas, DDS, MBA, BVAL |

ADS South, LLC
120 Istoria Drive
St. Augustine, FL 32095

Phone: (770) 664-1982

Why Should I Give You an Exclusive Listing?

Several years ago I was contacted by a dentist who was desperate to sell his practice. Although he already had a nonexclusive listing with another broker, he also agreed to list his practice with me in an exclusive listing, which meant that I would receive a commission even if the other broker sold the practice. (I told you he was desperate.)

We quickly received a full price offer for the practice. Shortly afterward, we got a call from the buyer telling us that he had seen the practice advertised by the other broker at aearl_douglas-xxs $100,000 lower price. So he lowered his offer by $100,000 since the practice was being advertised at that lower price.

Why was the other broker listing the practice for $100,000 less? The reason is that the practice was a newly-started practice, and it experienced very rapid growth in the early years. The other broker had valued the practice several years earlier and had not updated the practice financials in several years. So while the numbers were appropriate when it was first listed, they were seriously out of sync with the current practice revenues.

This seller’s experience of dealing with multiple brokers points out how expensive an open listing can be, especially if one of them does not do biannual updates and provide current financials.

As one broker put it, “We all fish out of the same pond,” which questions the benefit of open listings. Brokers all talk to the same prospects, so the expectation that more brokers mean more prospects is without merit. Serious brokers market extensively through websites, contacts, referrals, etc. to develop purchaser prospects, and purchasers have no problem finding all brokers who might have a practice for sale. Most brokers are already in contact with nearly every prospect.

The problems with an open listing begin when a prospect hears about a practice three or more different ways from three or more different brokers. It’s doubtful that any two of those listings even sound as if they are about the same practice. The results of three people trying to sell a practice to a single candidate are disastrous, and what could have been a well-managed sale by a single, competent broker can quickly disintegrate into chaos, and frequently a lost sale.

Consider also that when sellers are not committed to brokers, brokers will not be committed to them either. So these sellers will be at the bottom of several brokers’ lists rather than at the top of any one broker’s list. A seller with an exclusive listing should expect commitment from his or her broker, and if that broker does not make a committed best effort, there should be provisions for termination.

When a sale finally does take place, a seller may face another serious dilemma. Remember, “We all fish out of the same pond,” so a seller may be told by two or three brokers that they were the one to identify a buyer and they should receive the commission. It is not unheard of that lawsuits and all manner of legal actions arise from what should have been a happy closing.

Open listings are even worse for brokers, who put in their time, talent, and money, only to end up helping the seller close a sale of his own doing. After all, sellers have the broker’s commission to bargain with.

This leaves us with the question: What is the best approach for listing a practice for sale? When sellers ask about having an open listing and engage every broker out there to try to sell their practice, I share issues discussed here with them. I tell them they will be better off with one mutually committed broker relationship, even if it isn’t with me. My best suggestion is that they exclusively list with a broker who has a network of resources that includes other brokers, and that the broker is willing to pay a fee to any referrers who provide a buyer. This provides the benefit of exposure to multiple brokers and still maintains a unity of effort, which leads to the absolute best selling experience.

 

by Earl M. Douglas, DDS, MBA, BVAL