In 2015, I was holding a three-day Airway Prosthodontics workshop in San Antonio. At a break on the final day, a participant approached me and asked very aggressively, "What is my ROI?"

My mind went blank. The first thing I did was run through every permutation of the letters ROI. I came up with some really interesting ones! I quickly recovered and figured out that she wanted to know how she was going to get a return on her investment in the course and screening tools.

It was a great question that, at that time, I had never put into words. I was so wrapped up in the discovery that I lost my focus on the realities of private practice.

Since then, I have spent quite a bit of time thinking about that question and today my five ROI's are: Intellectual, Business, Professional, Financial and Product.

Intellectual ROI in dentistry

Intellectual is the area that I am the most excited about. It appears, at first blush, to provide the least economic return; but that is short-sighted. Airway analysis has begun to provide answers for many of our failures. It also can assist us with improving the predictability of our care.

As an example, one possible explanation for flat incisal edge wear is that the patient is seeking an improved airway during the day. They are protruding their mandible and holding it in place on their front teeth. If that is true, they will need a place to land on your new ceramic so that they can breathe. It might also stimulate you to ask why they are required to make that move during the day.

This has led to a co-discovery of many issues that would have otherwise been overlooked or left untreated. I think of it in the same vain as an occlusion or facially generated treatment planning (FGTP) course. It will forever change your diagnosis and treatment planning. Those changes can absolutely be seen in the "bottom line."

tooth wear

ROI from the business of dentistry

The business of dentistry is to market your skills to the greatest number of people possible. Dysfunctional breathing impacts every patient in your practice to some degree. They cannot go to sleep and stay asleep. Their husband snores and holds his breath when he sleeps. Their best friend’s son is still wetting the bed and has just been diagnosed with ADHD. Their mother was told she has a touch of dementia. Their brother has flattened his teeth and has destroyed the enamel with erosion.

All of these patients could have a airway-related issues, and many of them could be addressed with dental treatment options. Even if the treatment is ENT surgery, your practice profits from the word of mouth of being the professional that finally figured out how to help. People are now routinely flying across the country to seek care from dentists that can act as an advocate for them in holistically fixing their sleep and airway issues.

Professional ROI in dentistry

This speaks to the airway evaluation and interdisciplinary team. In order to diagnose and treat our patients, dentists must form relationships with the medical community.

Our ability to detect and treat before the onset of disease is intriguing to our medical colleagues. This provides the opportunity for dentistry to finally be seen as a health care profession. While there are still ongoing discussions in our teams about the lack of "medical evidence" for some of our treatment strategies, many physicians and their family members routinely seek the care of an airway-centric dentist to prevent, control and resolve airway issues.

Financial ROI in dentistry

return on investment in dentistry

This includes marketing your business, but goes further into getting more people to accept care. 

In the FGTP courses, the Spear faculty recommend that you do not sell people on treatment plans. Instead, you show them what other people in similar situations have done and offer them the opportunity to choose that care for themselves. We usually attempt to provide a few different approaches to allow them flexibility in their choice. I almost always find that there is an "ideal" plan. Today, one of the most important parts of my treatment presentation is, "Which one of these plans makes my airway improve the most?"

The Seattle Protocol has been a valuable tool to provide a proof of concept for our patients. Because we find a control strategy to improve their sleep before we present the dental plan, we have found a dramatic improvement in our ability to provide closure on case presentations. Many of those bigger dental cases that you have been working so hard to treat will have a concrete reason to stop delaying care.

ROI from dental products

Products to assist breathing are always fabricated when we complete the Seattle Protocol on adults. This can range from traditional splints to sleep appliances. It depends on what is required to address the signs and symptoms of the patient.

The Protocol allows the flexibility to focus on both the patients with flow-limited breathing and severe sleep apnea. Additionally, it allows many of the products to be dental appliances that restorative dentists are familiar with and comfortable delivering. 

"What is my ROI?" Years ago, I would almost apologize for what I felt was a lack of direct ROI.  I kept thinking about courses that taught me to do a procedure that I could do the next week.

The problem is not the ROI on Airway Prosthodontics. The problem was with how I was defining the value. Today, I can say with confidence that there are very few courses that will have the impact on your practice like the Airway Prosthodontics course at Spear Education. Learning about the breathing and sleep issues of your family and your patients will provide a return that is absolutely worth investing in.

Jeff Rouse, D.D.S., Spear Faculty and Contributing Author


Commenter's Profile Image Carl S.
July 6th, 2017
Great article Jeff. I am not certain that ROI of treatment is equated to ROI of marketing. Adding treatment options adds to bottom line. Marketing hopes to improve bottom line. Where can we find more info on the Seattle Protocol? Carl
Commenter's Profile Image Jeff R.
July 6th, 2017
Good observation Carl. I should have highlighted that when you are comfortable managing airway patients, marketing that skill provides an opportunity to bring in more business. The Seattle Protocol will be presented in the Airway Prosthodontics Seminar August 18-19, 2017 and December 15-16, 2017. The Airway Prosthodontics Workshop on October 26-28, 2017 will be 3 days of hands-on activities completely devoted to the Protocol. Details are on the website.