The Road to Success


From Dental School to an Expanding Practice in Five Years.
In 2014, I graduated from The Ohio State University College of Dentistry in Columbus, OH. Today, about five years later, I own a dental practice in Stonington, CT, and I am in the process of acquiring two additional practices in Rhode Island. Our goal is to build a small group practice.

My team and I are often asked what the secret is to the early success of our practice and what motivates us to create a group practice. The simple answer is that our success is driven by the strength and unity of our team, and our desire to grow has been ignited by the passions and beliefs we have in common. Everyone on my team shares a paramount goal: to deliver the highest quality dental care in a holistic and personalized manner.

Early Mentor
Dr. Les Prasad, a family friend and dentist in Cranston, RI, guided me to the right path early in my career. He encouraged me to take several continuing education (CE) courses to build on the skills I had developed in dental school. While there, I did voluntary externships with Dr. Prasad. This provided me with initial exposure to high-end cosmetic dentistry, as well as a caring and personalized treatment philosophy.

After that experience, I knew the direction I wanted to take for my own career. On Dr. Prasad’s advice, I enrolled in the New Dentist Program with the Dr. Dick Barnes Group (DDBG) in Salt Lake City, UT, even before I graduated from dental school.

After graduation, I moved to Rhode Island and became an associate with Dr. Prasad. I began to implement all of the skills and techniques that I learned from him and the CE courses I was taking.

In his practice, Dr. Prasad had already successfully implemented strategies for patient management and case presentation. Since he was using a lot of the techniques I learned in the New Dentist Program, it was easy for me to follow in his footsteps and do the same. I am grateful to Dr. Prasad for his guidance and am very fortunate to have him as a mentor throughout my career.

Firsthand Experience
Since I was only working with Dr. Prasad part time, I got a second job with a nine-location group practice in Rhode Island. That experience was crucial because it gave me insight about how a group practice operates. I figured out what I liked, what I didn’t, and how I wanted to run my own practice. It was also eye-opening to see the vast differences that exist among dental providers with regard to treatment philosophies, treatment planning, and execution.

Soon after joining the group, management encouraged me to lead the other dentists in the group and implement the practice methods that I had learned from the DDBG. I arranged for the dentists to take the Everyday Occlusion and Full Arch Reconstruction CE courses to encourage them to utilize better clinical strategies and techniques.

Senior management and I also attended the DDBG’s Total Team Training course with the goal of inspiring the rest of the team members (both clinical and administrative) to implement this type of comprehensive dentistry.

During this time, we realized that, due to the varying levels of experience and skills among the 17 dentists in the group, a simplified course was needed. I worked with the DDBG and one of their clinical instructors, Dr. Jim Downs of LêDowns Dentistry in Denver, CO, to create a specialized course called “Beyond the Basics.” It focuses on mastering the basic principles of dentistry. The course was based on the premise that “you have to walk before you can run.” The course was so successful, it was incorporated into the DDBG curriculum, and today I help teach the course with Dr. Downs.

As exciting and wonderful as full arch and full mouth rehabilitations are, dentists must first master a single unit, bridge, or quadrant in the most efficient and qualitative way. The dentists in this group learned that there are better and more efficient ways to perform dentistry than those they had been employing for years.

A New Practice
Within a couple of years, the group practice began to evolve into a dental service organization (DSO), with many changes that no longer aligned with my philosophy. Some colleagues in this group who shared the same philosophy and goals ended up leaving. Soon afterwards, I knew that it was also time for me to take a leap of faith and start out with my own practice.

Once my decision was made, I was presented with the opportunity to purchase a well-established practice in the idyllic town of Stonington, where high-end cosmetic dentistry was already being practiced. I knew this was the perfect fit for me, and I only needed the support of a great team to make my dreams come true.

The Dream Team
The first people I contacted about possibly joining my team were two former members of management from the group practice: Samantha Burnell, the former COO of the group, and her “right-hand woman,” Amanda Kirwin, who oversaw personnel and operations.

When the group practice changed to a DSO, Samantha and Amanda left and started a dental consulting company. Since I, too, had decided to leave shortly after they left, we decided to team up. The three of us had already built a relationship based on our shared passion for patient-centric dentistry.

Samantha’s background brought invaluable skills to the team. She began her career as a dental assistant and gained experience in every dental specialty while she was studying to obtain a degree in dental hygiene.

Amanda is trained as a certified dental assistant, and has experience assisting in almost every specialty in the dental field. She is a front desk administrator who can perform all of the front desk and dental insurance duties, as well as manage our social media accounts and medical billing.

Samantha and Amanda were largely responsible for leading the group’s acquisitions and transitions, and were instrumental in growing each practice. This experience gave them a great understanding of dentistry as well as business management.

Deciding to strike out on my own with the “dream team” was the best decision I ever made. As a team, we realized almost immediately that this was what we were meant to do. We got right to work, bringing in new technologies, expanding the treatments we could offer, and implementing transparent systems by utilizing cloud-based technologies on both the dental and business ends. Having our systems easily accessible allows everyone to check on what’s going on clinically and financially.

Today, Samantha and Amanda handle everything from human resources (such as hiring staff, writing policies and manuals, training team members, etc.) to bookkeeping, renovations, marketing, and social media—in other words, nearly all aspects of our operations. The only services we currently outsource are tax filing and IT support, which saves money and allows us direct oversight of all other aspects of the dental practice.

I focus the majority of my time and energy on dentistry. Having a strong team enables me to engage in guest lecturing, attend high-end CE courses to expand my credentials, and look into new technologies and techniques that improve the patient experience. I am a recent Diplomate of the American Academy of Dental Sleep Medicine and am excited to offer those services to our patients.

We have been fortunate to inherit other amazing team members in Stonington—Traci, Dale, and Nancy—who have supported our mission since the first day. Our team has expanded, and now three of our former colleagues—Kaitlyn, Amber, and Lisa—are current members of our team. Other former colleagues who know what we are trying to accomplish have reached out, seeking to join our team. This has motivated us to expand our practice into a small group.

Our group is based on the principle that treating patients and employees well leads to success. We focus on empowering the team to continually learn and think independently. I want our hygienists and assistants to help me identify dental issues, find their causes, and understand and discuss the possible treatments and outcomes with patients.

Many of my team members have been in the dental field longer than I have, so it would be a shame to not take advantage of their knowledge and experience. Getting the same information and advice from multiple providers gives patients better understanding and greater comfort, which leads to a ready acceptance of treatment suggestions.

Encouraging the team members to be involved motivates them to have an ownership mentality, which in turn creates a team spirit with everyone playing a role. We all understand that how well we do our part affects the rest of the team and our patients. This leads to individualized care, which our patients notice and appreciate.

Personalized Treatment
We offer personalized, comprehensive treatment focused on best practices, rather than treatment dictated by insurance. Individualized treatment helps independent dentists stand apart from the dental corporations that are becoming commonplace.

Dental insurance has already become a “supplement” rather than true “insurance,” and many dentists have succumbed to the temptation to allow insurance companies to dictate the treatment they provide. Due to the increasing costs of health insurance, many employers are no longer providing dental insurance, and now it is not just retirees who are uninsured.

Because of this, our practice offers an in-office savings plan as an alternative for patients who do not have dental insurance. We offer this plan so that people can get the treatment they need and desire. Our patients have been saving thousands of dollars with the in-house savings plan, which we implemented immediately upon opening our practice.

Neither my practice nor my team are insurance-driven. We focus only on best practices and predictable outcomes to determine our treatments. We try to fully utilize insurance for our patients—it is difficult to move away from an insurance-driven mentality, and not every dentist can do it. We are fortunate that our patients truly value the services that we provide.

For a dentist, being confident, believing in what you say, and not wavering are keys to case acceptance. Sometimes doctors get into a negotiation with patients, but patients should never dictate treatment. That only causes them to “shop around.” As the doctor and the expert, the dentist should dictate treatment.

Some of the tools we use to educate our patients include the following:
• Utilizing proper verbiage to show value to patients. We learned this from the Total Team Training course.
• Using both intraoral and extraoral photos. These help to educate patients on their situation and the possibilities for their future.
• Using the American Academy of Cosmetic Dentistry (AACD) photo series.
• Showing before-and-after photos. We highlight similar cases to help patients understand the outcomes they can expect as a result of treatment.

Focus on Dentistry
Most dentists get bogged down with everyday practice management, human resources, finances, accounting, and data analysis—none of which are taught in dental school. It’s easy to obsess over such matters, but they can distract a dentist from his or her true focus.

As a clinician, you should be focusing on patient care. I am able to do just that because of the great people I work with. I trust and respect my team members. In addition, we have set up simplified, transparent systems with checks and balances so that it is easy for me to monitor everything.

Seeing team members who are happy at work every day, and who feel rewarded both emotionally and financially, is another main reason why we believe that growing our group is the right thing to do. With our team in place, I can feel confident that even as we expand, I can stay focused on dentistry, mentor new dentists who join our group, and collaborate with other like-minded colleagues.

Our goal is to build a group of professionals who share our philosophy and ideals so that collectively we can provide high-quality dentistry to an ever-growing patient base. Whether we achieve that by growing our group, or by providing consulting services, we want to do what we can to keep the practice of dentistry in the hands of skilled and caring service providers. With each patient we treat with our patient-centric philosophy, we inch closer to this goal.

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Dr. Shanthi Cariappa was born and raised in Cincinnati, OH. It was her dream to become a dentist, and she wasted no time in pursuing that goal. Dr. Cariappa earned a Bachelor of Science degree from Adelphi University in Garden City, NY, and graduated in 2014 from The Ohio State College of Dentistry in Columbus, OH. Since then, she has been an associate in private practice in Rhode Island, and now has her own dental practice in Stonington, CT. Dr. Cariappa has taken extensive continuing education courses not only in cosmetic dentistry, but also in sleep apnea diagnosis and treatment, full mouth rehabilitation, aesthetic removable prosthesis, dental anxiety treatments, and many other areas. Her goal is to provide the most comprehensive dental care for the whole patient, and not just their teeth. Dr. Cariappa is a proud member of the American Dental Academy, the Academy of General Dentistry, and the American Academy of Cosmetic Dentistry, and is a Diplomate of the American Academy of Dental Sleep Medicine. Being an active member of these organizations is important to her, because she has a commitment to her patients to continue learning and growing, and to always be at the forefront of the ever-changing field of dentistry.