Think Bigger

The days when a dental laboratory's potential client base was limited to its local area are no more. "I ask dentists if they have seen those brown trucks with ‘UPS' on the side in their neighborhood," says Jay Collins, Owner of Cornerstone Dental Lab in Bristol, Pennsylvania. "If they see those trucks, then I am their local laboratory. Wherever that brown truck can go, I can go."

Advantages still exist for local service, of course; local deliveries and in-person interactions likely will never be truly matched. However, increased clinician adoption of intraoral scanning and the normalization of videoconferencing since the COVID-19 pandemic have mitigated those factors significantly, to the point where an argument can be made that any laboratory that is only seeking local accounts is unnecessarily limiting its ability to grow.

Dimitri Tsichlis, CDT, and his wife, Lidia Croteau, did not set out to build an international client base for StyleDent Dental Laboratory in Canada. "When we started," Tsichlis says, "we only had clients who were literally on our street." As the business grew, however, they eventually found themselves in a position to open a second location 1,500 miles away in Winter Park, Florida. "Our team in Montreal was built to be self-sufficient, and we had clients in so many different places, so nothing was stopping us from pursuing our dream of a lifestyle change by getting away from the cold and the snow," Tsichlis says. The two laboratories now serve clients not only around North America but in Ireland, France, and Trinidad, and this year Tsichlis opened SGT Guides, a second Florida laboratory specifically for stackable surgical guides. "We are in a niche market," Tsichlis says, "and extending our reach allowed us to find our tribe. We are able to connect with more like-minded dental professionals than if we limited ourselves to one area."

Collins says his laboratory's growth has been organic as well. Cornerstone had a few DSO clients who expanded to other parts of the country, and the laboratory merely followed them. "We did not sit down one day and plan a new initiative to go national; we basically followed the money," Collins says. "You can only reach out so many times to the same people in your area. But when one of our sales representatives was traveling to Tennessee, for example, to meet seven new offices that one of our DSO clients acquired, they also visited other practices in that area."

National expansion was more deliberate for some other laboratories, such as Aurora Dental Lab in Auburn, New York. When Chief Operating Officer Keith Miolen, CDT, joined the Aurora team in 2015, he had large aspirations. "The first thing I focused on was restructuring our production wheel," Miolen says. He implemented different shifts for each department so that cases would continue moving 24 hours a day. "I knew if I could provide a quality product with a quicker turnaround time, we could grow," Miolen says. "Once we had our production wheel in place with good standard operating procedures, we focused on telling DSOs about how that would allow us to grow with them. Once we established that, we were doing work all over the country in just a matter of weeks."

Conrad J. Rensburg, ND, NHD, Owner and Head of Dental Implants for Absolute Dental Services in North Carolina and South Carolina, was more of a skeptic initially. For most of the laboratory's first two decades in business, close to 90% of its revenue was generated within a 90-minute drive. Rensburg believed that in-person communication was essential to controlling and sustaining a business. However, when Director of Signature Prosthetics Jack Marrano, CDT, joined the laboratory in 2018, he convinced Rensburg to try expanding nationally, and the results have been overwhelmingly positive. Rensburg says almost 45% of their sales came from national accounts in 2021, and that the laboratory's largest branch (Durham, North Carolina) received 55% of its physical impressions by mail. "In 3 years, we completely changed the landscape of our revenue generators," Rensburg says.

As much as Rensburg's landscape changed, in many ways it stayed the same. Despite pursuing accounts whose practices they might rarely—if ever—visit in person, Absolute's value proposition remained the same. "I do not sell hybrids," Marrano says. "I sell relationships. World-class hybrids are a byproduct of world-class relationships." Rensburg and Marrano started by targeting dental schools—specifically prosthodontic students. "Jack's motto was always that if you build relationships with the students when they are still hungry to learn, you can teach them things," Rensburg says. "That is when you can build a relationship for a lifetime." Maintaining those relationships involves attending clinical conferences and visiting practices, but the more important element is doing good work. "Our team does a really exceptional job of building relationships through case guidance and helping clinicians achieve more predictable outcomes," Rensburg says. "At the end of the day, we are not here to be their friends; we are here to be their support structure."

Collins engages in more traditional sales and marketing strategies, including phone calls and direct mail. However, the angle within those strategies has been the key to Cornerstone's success. "We have built our sales strategy on one word, and one word only: pain," Collins says. "Whether it is a DSO with 10 offices in Tennessee or a solo practice in Biloxi, Mississippi, we are trained to find pain. When we ask what problems they are experiencing, they talk about their current laboratories. We respond, ‘That's a great laboratory. Why am I here today?' It could be that they do not have a relationship and they want someone to talk to, or that turnaround time is really suspect. Once we identify that issue, we cater our solution to what their problem is. The big three are price, quality, and turnaround time, but price is usually either the last factor mentioned or it is not mentioned at all."

Collins also acknowledges the potential effectiveness of social media, though he says it is easier said than done. "I have found that you need to be both consistent and genuine," Collins says. Erik U. Niederhauser, CDT, CEO of Pink Dental in Sterling, Virginia, notes that quality cannot be sacrificed in the name of quantity for social media. "Photography skills are what it is all about," says Niederhauser, who opened his laboratory just 2 years ago and built an international client base exclusively through social media and word of mouth. "In order to set yourself apart from the competition, you need better pictures and/or better content. Just posting your regular work every day will not attract anyone. I see accounts with thousands of posts but barely any engagement because they are nothing special." Quality can also come in the form of strong content beyond photography. Rensburg's laboratory hosts "Absolute Talks" videos that generate large amounts of engagement. "You need to bring value," Rensburg says. "For example, we had a very successful episode on single-wing Maryland bridges, which the research indicates actually work better than double-wing restorations. Content like that drives a national fan base. You are trying to have 200 or 500 people watch it and tell 10,000 people about it. That brings value, which brings trust, which, at the end of the day, brings referrals." If social media content is strong, Niederhauser says that method of marketing can be more effective than traditional sales; while getting past the front desk is often a challenge on sales calls, most people spend at least a few minutes each day scrolling through social media. "They will come across my work," Niederhauser says, "and if it is pretty enough, they will engage with it. Social media allows dentists to see what is possible and compare it to what they currently get. That is how we engaged the US market, and it has been quite lucrative. Those are also clients I can keep for life because they found me rather than vice versa; locally, you really need to fight to get clients, but social media takes that out of the equation because it is just about your work." Saro Hatzakortzian, CEO of Alien Milling Technologies, notes that Facebook groups are a particularly active spot for networking via technical discussions. "There is so much knowledge and engagement in those groups," Hatzakortzian says. "I would recommend that any laboratory participate." Calculating an ROI for social media efforts can be challenging, but the evidence exists from laboratories that have marketed successfully that way. "At the recent Florida Chapter meeting of the American College of Prosthodontists, six or seven people I had never met asked to take pictures with me," Marrano says. "They had seen our social media and were fans. That is when the reach starts expanding."

Social media marketing is part of building a national brand for the laboratory, and another element of that is visibility at industry events. Niederhauser says high-level educational events have helped him connect with dentists around the world. "Education attracts like-minded people who are willing to go that extra step," he says. Rensburg has even found that raising his national profile on the laboratory side has been beneficial. "Five years ago, nobody knew us because we did not care to go outside of our customer-to-technician relationships," Rensburg says. "Jack said we needed to start attending more technical shows such as Cal-Lab and even start presenting on these stages. I underestimated the value of collaboration within the industry. We built this little island, and we protected our island. We never went out and communicated with our peers about our ideas and experiences. That is one spoke in the wheel that I had previously missed, and I really enjoy being part of that community now."

Of course, marketing is only part of the battle in business; retaining accounts is the next step. Rensburg agrees with Niederhauser that, in many cases, retention is easier with national accounts. "We have learned that high-quality work with really good customer service will maintain that customer base," Rensburg says. "A national customer will always dabble in a local laboratory, but as long as your service and delivery times are high-quality, that customer will always come back to you. The difference between local and national business is that national business is maintained by high quality and really good service, whereas local business is maintained primarily by more traditional, face-to-face relationships combined with high-quality work, but videoconferencing has made the world a smaller place."

Zoom, Microsoft Teams, FaceTime, and other videoconferencing tools have become ubiquitous parts of our daily lives since the onset of the pandemic. "We can go over the case and pinpoint certain things using a 3D virtual preview, and then we have periodic checkpoints for additional meetings," Niederhauser says. Collins says he calls dentists on a videoconferencing app without even checking beforehand. "It has helped so much with that local feel, to the point that dentists now call me often with patients in the chair," Collins says. "I use it for local dentists as well; it is such a great tool."

More advanced, dental-specific communication tools are available as well—some proprietary to clients or scanner manufacturers, and others to laboratories themselves. "We utilize multiple web portals that allow us to expedite communications and keep them continuous," Miolen says. "Instead of spending 8 hours per day on the phone like I once did, I can delegate to my team and troubleshoot only the most challenging issues myself. It has rearranged and enhanced my communications to allow me to be more efficient in serving our clients."

Tsichlis says simply meeting a client face-to-face is important. "Especially when it is their first case, I always like to put a face to the client, and for them to meet me," he says. "Even virtually, it makes a difference."

Scheduling becomes more critical for remote cases than for local ones, as the consequences of missing a deadline by a few minutes can mean adding a day of shipping time. "As much as we hate to do it, you can deliver a local case at 8 AM for a patient whose appointment is at 9 AM," Rensburg says. "For a national case, if you miss the shipping deadline, you are done. Paying close attention to delivery times is crucial, especially for larger, more complex cases." The variation in different types of shipping costs is important as well; Collins says his laboratory typically tries to use ground services. "We are trying to be as profitable as possible, so we do not want to spend money on next-day air to Florida," he says. "That means finishing a case 3 days earlier than if it were local. It adds a little extra pressure, but cheaper logistics are important." One option to mitigate that factor is to pass shipping costs along to the customer. "That opened doors for us worldwide," Hatzakortzian says.

Overall, Tsichlis emphasizes the importance of consistency for local and national cases, even if certain pieces of information might be obtained in person vs digitally or by mail. "We have learned to have a non-negotiable protocol for each type of case," he says. "We need to communicate on the same level for all cases that we do for dentists down the street." Miolen says using high-quality equipment, especially scanners and software, is a key to providing that consistency. "Your scanner and your software are your links to dentists," Miolen says. "Because of the technology I have invested in, I am able to utilize the same standard operating procedures and manufacturing processes whether a dentist is down the road or in Ohio."

Working with a national client base does not mean no longer pursuing local accounts, of course. Niederhauser notes the increasing popularity of in-house laboratories among dental practices. However, the national market is a viable option for nearly anyone to find more accounts that are ideal fits.

"Most dentists will prefer a local laboratory, but there are some things that laboratories in certain areas just do not do as well as others," Rensburg says. "Then, there are some dentists—and I see this even in our local areas—who just like to send work across the country because they think a laboratory on the West Coast must do it better than one on the East Coast, or vice versa."

Niederhauser has been targeting a national and international audience since he first opened his laboratory because he identified a niche (high-quality hybrids) and wanted to develop a client base that fit that niche as well as possible. "The local dentist pool may be 20 or 30, whereas the international pool is more like 200,000 to 500,000," he says. "They are all looking for better work to compete with their own neighbors. For any laboratory looking to grow, jumping into that pool is much more attractive."