Dr. Terry Vines examines longtime patient Tom Sertick, 68, in his Redlands… (Gina Ferazzi, Los Angeles…)
For a quarter-century, Dr. Terry Vines built his Redlands dental practice the old-fashioned way: one mouth at a time.
Vines sponsored youth soccer teams. He renovated historic buildings around town to build good will. He turned his waiting room into a cozy nook with soft chairs and a big-screen TV.
As business increased, Vines hired more dentists to accommodate his thriving practice, Pure Gold Professionals in Dentistry.
Then the economy tanked, hundreds of patients stopped coming, and Vines decided he needed help.
Scouring the Internet and dental magazines, the 53-year-old dentist discovered a host of marketers and consultants — all promising to make dentistry pay.
For the right price, the marketers would unlock the mysteries of success, offering seminars and coaching sessions with titles like "Profit Centers for Your Practice" and "Secrets of the Dental Insurance Industry."
This year, Vines hired one of the marketing firms, Excellence in Dentistry. The Indiana company redesigned his website, adding colorful photographs of his staff, biographies of the office's six dentists and glowing patient testimonials. "I would definitely recommend these caring and gentle people to any of my friends and family," a patient says in one of the tributes.
In 2012, Vines' consultant plans to launch an email newsletter for patients and a blog to promote teeth-whitening techniques, new laser technology to identify cavities and other services.
Vines also intends to give patients a little post-treatment pampering, supplying warm towels to go along with the bottled water in the waiting-room refrigerator.
"It's time we step it up," said Vines, who cut back his hours over the last two years when revenue dropped about 10%. "I believe I'm in a position to grow with the right marketing."
For years, dentists relied on their good reputations to attract customers, figuring it was enough to hang a shingle, perform a valuable service and earn a trusted name.
That was before patients started skipping twice-a-year cleanings, postponing fillings and taking a pass on root canals.
Dentistry, once thought recession-proof, has become a casualty of the tough economy. Americans increasingly see dental care as a luxury, even though neglecting their teeth can lead to serious health hazards, including heart disease.
Dentists say many patients no longer can tap equity in their homes to pay for implants and other elective treatments. Bank financing for dental work, long a popular way to pay for care, has dried up as lenders stiffened loan standards.
California's budget crisis has contributed to the problem. The state sharply slashed funding for its Denti-Cal program for the poor two years ago, leaving vast numbers of low-income adults without dental coverage.
Dentists are feeling the pinch: Revenue at American dental offices has dropped steadily over the last three years, according to financial data from nearly 8,000 practices collected by Sageworks Inc., a financial analysis firm in North Carolina.
This year is shaping up to be the worst since 2005. In the first nine months of 2011, dentists have reported an average 3% decline in revenue and profit.
The downturn has forced dentists to cut hours, lay off staff and slash their own pay. Many remain worried. In an August survey by the American Dental Assn., 45% of dentists said they were "not at all confident" about future economic conditions. Older dentists were more downbeat than younger ones.
"Right now, your practicing dentist is very unsure of where the future is going," said Dr. Matthew Messina, a Cleveland dentist who serves as a consumer advisor for the American Dental Assn. "We're looking for any ray of sunshine."
Dr. Luis Dominicis has responded by working harder. He extended weekday hours at his Downey dental practice, and he sees patients two Saturdays a month. He hasn't raised prices in five years and said he has no intention of doing so, despite rising costs for anesthesia and other supplies.
"You've got to stay competitive," Dominicis said. "At least I'm able to put in the extra hours."
The sense of uncertainty has created an opening for marketers. One of the most successful, DentalWebsites.com, said its client roster has doubled in the last 18 months, to about 800 customers.
The West Virginia company charges an average $5,000 to design websites, and $300 to $400 more each month to update the sites and position them on Internet search engines, among other services.
The firm is owned by a husband-and-wife team, Greg and Mary Rahall. He's a computer engineer; she has a master's degree in industrial relations. They got their start in dental marketing more than a decade ago when they created a website for a dentist in their family, who recommended them to others.
"I feel great that our business is booming," Mary Rahall said. "We help dentists get a bigger share of a shrinking market."
Not all dentists are sold on marketing as the answer to their difficulties.