Mike DiFrisco, the American Academy of Cosmetic Dentistry’s Chief Marketing Officer, talks about the AACD’s recent survey of the industry and the results. The AACD have been conducting surveys on the industry for 20 years, and their last survey was conducted in late 2022. The survey was sent out to both AACD members and nonmember dentists to get a better understanding of what has changed in the industry and what has stayed the same. Mike is excited to see the results of the survey, as it will provide valuable insight into the cosmetic dentistry industry
Highlights
[00:12] The State of the Cosmetic Dental Industry
[02:41] Analysis of AACD Member Survey Results for 2022
[04:41] Survey Results of AACD Members
[09:12] Increasing CAD/CAM System Usage in Dental Practices
[10:46] The Future of Cosmetic Dentistry
[13:29] Discussion on Disruptors to the Cosmetic Dentistry Economy
[15:58] Appropriate Spend for Marketing of Practice Revenue
Resources
- Learn more about All-Star’s Insurance Freedom Webinar
- Learn more about the American Academy of Cosmetic Dentistry
- Learn more about All-Star’s Hiring Service
About Michael DiFrisco
Michael DiFrisco, founder of How-to-Branding.com, has worked on the marketing and branding teams of nonprofit associations for most of his professional years. In addition to leading the brand charge for diverse organizations including the Experimental Aircraft Association (EAA) and Ducks Unlimited, DiFrisco is currently the Chief Marketing Officer for the American Academy of Cosmetic Dentistry (AACD). DiFrisco has more than 25 years of experience in helping businesses effectively connect with their target audiences through strategic-level mission relevance, brand oversight, consistency, coordination, and efficiency in marketing communications. He has also successfully completed the AACD Educators Academy providing the skill set to be a compelling speaker leader. DiFrisco is the author of How to Craft a R.A.D.I.C.A.L. Brand for Your Business, and Shadowcasting: Growing Your Business by Growing Your Reputation.
About Alex Nottingham JD MBA
Alex is the CEO and Founder of All-Star Dental Academy®. He is a former Tony Robbins top coach and consultant, having worked with companies upwards of $100 million. His passion is to help others create personal wealth and make a positive impact on the people around them. Alex received his Juris Doctor (JD) and Master of Business Administration (MBA) from Florida International University.
Episode Transcript
Transcription performed by A.I. Please excuse the typos.
00:12 – 00:33
Alex Nottingham JD MBA
Welcome to Dental Allstars. I have Michael de Frisco. He’s the chief marketing officer for the American Academy of Cosmetic Dentistry, the AICD. And our topic is Responsible Esthetics ACD State of the Dental Industry. Please welcome Michael.
00:34 – 00:36
Mike DiFrisco
Thanks for having me here, Alex. Glad to be with you today.
00:37 – 00:48
Alex Nottingham JD MBA
Well, tell me, Mike, what is going on? What did the AICD discover in the state of the industry? The State of the Union? What’s going on, Mike?
00:49 – 01:10
Mike DiFrisco
It is our State of the Union. And and, you know, A.C.T. has been conducting this survey for about 20 years now. It’s about half our history, believe it or not, because we’re coming up on our 40th anniversary next year. So this is an area where the academy has established and kind of maintained thought leadership because we benchmark the results.
01:10 – 01:38
Mike DiFrisco
We observe kind of what dynamics are changing over time in the cosmetic dentistry industry and not only how it affects the Academy’s members, but it cosmetic dentistry industry as a whole. So what’s kind of interesting is our last survey was conducted in 2019. We usually do it every other year, but of course we had to press the pause button during the pandemic because we kind of wanted to wait until things normalized a bit.
01:38 – 02:04
Mike DiFrisco
You know, we wanted to prevent seeing a lot of false positives or or information that was kind of pandemic focused. So we were really excited to execute this latest survey, which we did in late 2022, because like everybody, we wanted to see, you know, what’s changed or even more so what’s stayed the same. So anyway, what’s kind of cool is the cosmetic dentistry state of the industry survey.
02:04 – 02:40
Mike DiFrisco
It’s not just sent to ACA members, but it goes to nonmember dentists as well. So we can make, you know, some comparisons between the responses this year. When we did it this year it was about 5050 active members and nine members, and about 9% of the respondents on the members side were the accredited members. So this is where we get some of our data, but it’s pretty evenly distributed between members and nonmembers, and almost all of them are dentists, with about 2% being laboratory technicians.
02:41 – 03:09
Mike DiFrisco
So that’s kind of what it looks like right now. We did see something interesting this year. About 11% of the respondents were orthodontists, and we’ve seen that steadily growing since 2015 when it was only 3%. So we thought that was interesting and this one’s not surprising. But Alex, you wouldn’t you wouldn’t be surprised, anyway, that AICD members are twice as likely to identify themselves as a cosmetic dentist compared to nonmembers.
03:09 – 03:36
Mike DiFrisco
Which totally makes sense, right? You identify with that community of practice that you’re involved with. So also a couple other demographic things that I’ll tell you about before we jump into the findings here. About half the respondents to the survey instrument have been in practice for 20 years or more. And we’re seeing kind of a continued trend of more respondents saying that their practice location is urban.
03:36 – 04:03
Mike DiFrisco
This year it was about 51% saying that, with 34% saying suburban. And then the balance, of course, being rural and small town. And finally, what we saw in this latest survey is that that type of practice is staying pretty steady year over year, with about 53% of respondents saying that their solo practitioners and 34% belong to a group practice.
04:04 – 04:13
Alex Nottingham JD MBA
Very interesting. Now, in terms of the procedures or treatments. How have they been trending over the past year? What, if anything, has changed?
04:14 – 04:41
Mike DiFrisco
Yeah. So we always ask about what procedures they’re performing, what treatments are performing in their offices. And what we heard this year was the top five in order this time for the 2022 survey was number one crown and bridgework. Next was anterior direct bonding. Then we saw bleaching and whitening come up fifth or I’m sorry, fourth was veneers and fifth was posterior direct a bonding.
04:41 – 05:06
Mike DiFrisco
So this is actually pretty consistent with the pre-pandemic survey in 2019 with exceptions being orthodontics, which actually declined among all member types and veneers, which actually increased by a couple of percentage points overall. We also ask, you know, which procedure do the respondents want to see more of? And this year what they said was they wanted to do more veneers.
05:06 – 05:36
Mike DiFrisco
About 39% of them wanted to see more veneer treatments come into their office cases followed by implants at about 18%. And finally, implant supported dentures coming in at about 9%. But typically what we see when we analyzed the respondents by member type and by respondent type is that pretty consistently inside members steer their patients toward less invasive treatments versus the non.
05:38 – 05:41
Alex Nottingham JD MBA
Interesting. Even though they orient towards cosmetics.
05:43 – 05:55
Mike DiFrisco
Correct right. It’s less invasive treatments which kind of aligns with a cdw’s mantra over the years which has been all about responsible esthetics.
05:56 – 06:09
Alex Nottingham JD MBA
Now, what about the patient side? What in terms of the survey, what is it saying about dollars spent on treatment and what other findings have you found from the patient perspective?
06:09 – 06:39
Mike DiFrisco
Yeah. Yeah. So this is another kind of area where we do some slicing and dicing of when we analyze the data based on who’s responding, is it an accredited member, a general member or a non member? And because of their well, their credibility and often their advanced esthetic training active members and especially our accredited members can typically charge more for the same procedures because, you know, they’re viewed or perceived by their consumer clients as kind of specialists of sorts, right.
06:40 – 07:14
Mike DiFrisco
So average prices reported by members were at least 10% higher for all procedure types. And kind of what’s interesting is we saw average prices increase the most among accredited members. They’ve been going up 22% since 2019, since ACD is really the only esthetic dental organization that has a credential. So it’s clearly a great marketplace differentiator and it provides that practitioner with with a little more credibility in the marketplace so that they’re able to do that.
07:15 – 07:27
Mike DiFrisco
Overall, though, average patient spend has increased compared to the previous survey among all respondent types. So it’s nice to see bright spots like that, especially post-pandemic.
07:28 – 07:38
Alex Nottingham JD MBA
What else in the study that you find significant or stood out? So you covered the the doctor side, the patients died. What else sparked your interest, Mr. CMO?
07:39 – 08:06
Mike DiFrisco
Yeah, well, what we’re seeing more and more kind of year over year, we’re seeing more adoption of technology, right? So for instance, active members, they use chair side cad cam 40% more than nonmembers. And what we also saw was that practices using CAD cam have higher patient spend. And frankly, we’re seeing the same dynamic with digital smile design and 3D printers.
08:06 – 08:44
Mike DiFrisco
So as dental practices embrace technology, they’re able to do more. They’re able to offer, you know, different treatments, less invasive treatments and charge more. The use of chair side CAD cam has really increased steadily since 2017. So we’re kind of seeing that spike up pretty quickly among when we when we look at active members versus accredited members, the use of chair side CAD cam has increased from 37% in 2017, 39% in 2019, and 40% in 2022.
08:44 – 09:12
Mike DiFrisco
So you can see this adoption rate kind of continue to increase. So when we compare AC members to the general dental population non members, we saw their usage of CAD cam increase from 24% in 20 1725. In 2019 and 31 in 2022. So it’s across the board. But AICD members are using technology and leveraging it a little bit more.
09:12 – 09:36
Mike DiFrisco
We’re also seeing and I’d love to hear your perspective on this from from your clients, but we’re seeing kind of cad cam system usage increase in step with the size of the practice, which kind of makes sense, right? Because if you have multiple associates under one roof in a practice and you can share the equipment, then your investment is is spread out over more associates.
09:36 – 09:38
Mike DiFrisco
Is that kind of what you’re observing as well?
09:39 – 10:02
Alex Nottingham JD MBA
Well, I’m glad you brought that up. I leave the deeds to you, the adult dental stuff to the academies. We focus on business training. Now, my coaches are seeing this in the front lines. So you’re going beyond my pay grade in terms of CAD and of course, technology. Now, the business related technologies, I’m seeing those being adopted. We can talk about that.
10:02 – 10:25
Alex Nottingham JD MBA
But from the clinical side, that’s why just for a background, for many of those that are listening, we’ve had a relationship with the AICD for over ten years when we launched All Star Dental Academy with Mike. Mike Driscoll You were you and your buddy Jeff helped us. We launched together All Star at the City and you all have been wonderful supporters for so many years.
10:25 – 10:46
Alex Nottingham JD MBA
And so we just had this vision that we’re going to do great on the business side, the practice management training. And when it comes to clinical, it’s going to be the EGD, it’s going to be the AICD and others that hold that clinical standard. And it’s just amazing what what you guys are doing and this the longevity of your people and support.
10:46 – 10:49
Alex Nottingham JD MBA
And so we’re just so happy to be aligned with you guys for so long.
10:50 – 11:18
Mike DiFrisco
Great. Great. We’re happy to have you as a as a business partner. And thanks for that explanation. That totally makes sense. So as we think more about, you know, technology and how dental practices are leveraging it, we’re also seeing digital smile design and 3D printing increase in the last couple of years since the pandemic, with four in ten or about 42% of respondents using digital smile design and about one third of practices using, you know, 3D printing.
11:18 – 11:43
Mike DiFrisco
So use of both has increased among member types but more among members, with digital smile design increasing 11 percentage points in 3D, 3D printing about 17 points among OECD members. But again, we’re seeing these technologies grow more among the group practices than than with the solo practitioners.
11:45 – 12:07
Alex Nottingham JD MBA
Now, you kind of alluded to earlier about the pandemic, and it’s kind of shifted in terms of the impact. Now it’s more supply, demand, prices. What do you see moving through 2023 into 2024 and so on? What do you see the future of dentistry, of cosmetic dentistry going forward?
12:08 – 12:38
Mike DiFrisco
Yeah, well, you’re right. I mean, there were plenty of disruptions, as we all know, during the pandemic, especially in those first few months when there was, you know, so much so many question marks kind of floating around dentistry in general. But what what our respondents told us in this 2022 instrument was as far as disruptions and things that they’re thinking about or concerned about, is is the continued growth of DSOs more corporate dentistry?
12:38 – 13
Mike DiFrisco
Right. And I know you’re very familiar with that, but they’re calling that a threat or a disruptor, and they’re seeing that grow the economy in general. Of course, higher costs, the availability of support staff. These are concerns that that cosmetic dentists have right now, and that was mentioned frequently. So disruption is to the economy. It was about 12%.
13:29 – 13:29
Mike DiFrisco
And they brought up specific examples such as higher costs that they’re dealing with in the office for supplies and consumables, supports staff shortages. 7% said that, and that increased the most compared to 2019. So no surprise there. We’ve all heard kind of the the difficulties in securing quality, quality team members and then, of course, insurance. So that includes like lower insurance reimbursement.
13:29 – 14:01
Mike DiFrisco
That’s a big hot button issue that we’re seeing right now, staffing, which I mentioned as a subset of the economy disruptor. So we got all these things kind of floating around the economy, including staffing. And the other thing that we saw was that COVID kind of prematurely drove a lot of dentists, you know, into retirement age earlier because of maybe preexisting risk factors or maybe they’re just kind of throwing up their hands of, I’m close enough and this isn’t worth this isn’t worth the effort.
14:01 – 14:08
Mike DiFrisco
So those were some of the those were some of the pain points that that came out of of the survey. And I’m sure you can relate to some of those.
14:09 – 14:28
Alex Nottingham JD MBA
What comes up for me is in terms of DSOs, I have this a future podcast. I’m thinking about a title called DSO, doing it right or DSOs doing it right. There are some DSOs that are doing it right and there are some corporate practices that are doing it right as well. And what I mean is they’re committed to patient service.
14:29 – 14:52
Alex Nottingham JD MBA
They’re investing in the quality materials. I think where there’s the aversion when from the AICD is such a commitment to quality and we talk about sometimes is that when you’re heavily impacted on cost or insurance, you have to use inferior products and nobody wants to do that. No practitioner wants to do that. So that’s number one, is that there are some that do it well, some that don’t.
14:53 – 15:14
Alex Nottingham JD MBA
And when we say do it well, we mean it’s not just a business decision, it’s quality and it’s good for everybody. The other thing, when it comes to hiring, I mentioned to you we have a hiring service precisely for that issue because it has always been an issue hiring. And we built a hiring program five years ago and we just kind of launch it to the public two or three years ago.
15:14 – 15:38
Alex Nottingham JD MBA
But it’s been well-received because now it’s even more difficult. And lastly, insurance. Great timing Mike we just launched at all star dental academy dot com slash freedom how to break free from Dependance of Insurance Webinar Free Webinar. So that’s very helpful in terms of a lot of dentists don’t want to be dependent and when I say dependent, they can keep the plans that they feel are helpful.
15:39 – 15:53
Alex Nottingham JD MBA
Some of these plans, they’re cutting 40%. And I know as a marketer, as a marketing guru yourself, how much let me ask you a question, Mike. How much is an appropriate spend for marketing of your practice revenue? You know, I’m going with this.
15:53 – 15:57
Mike DiFrisco
Yeah, yeah. I’ve. Right. That’s a common question.
15:58:07 – 16:22:15
Alex Nottingham JD MBA
5%, right? 10%. If you’re being really aggressive and often there you go and often insurance companies are like, well, it’s a marketing expense. Well, a, do you think 40% write off as a marketing expense? You’re basically paying the insurance company to work. You’re not making money on this. And when you look at the tracking, you find that the insurance companies aren’t really sending you a lot of patients.
16:23 – 16:50
Alex Nottingham JD MBA
It’s you just working with their plan. And often if you’re out of network in many of these plans, you still can get paid by the insurance company a higher fee. And we teach you how to do this in this webinar. So I’ll I’ll leave that link both for the hiring and for the insurance as well. And also, Mike, I like to for those that are listening about the fact I like to learn more about the ACA, either the study or more about joining or about your services.
16:50 – 16:50
Alex Nottingham JD MBA
Where will we go?
16:51 – 17:24
Mike DiFrisco
Yeah, well, just act Dealer.com. It couldn’t be a simpler web address. So see, that Will will kind of give you the the down low on everything that offers. I mean, we like to say that, you know, you mentioned it earlier, but we’re about esthetic excellence. We help dental professionals go further, faster with our with our education, our credentialing protocols, our online learning, our annual scientific session, all those ways that we can elevate the entire dental profession.
17:24 – 17:32
Mike DiFrisco
So that that’s. Thanks for mentioning that. Yeah. I would love people to check us out and see if we’re a good fit.
17:32 – 17:58
Alex Nottingham JD MBA
And what’s nice about ACG, you get member benefits, right? For example, with also dental academy, they get discounts and other companies as well. Also who’s the best fit to be a member and there are different member capacities that you can be involved in, right? Different levels, different interaction. So it’s not all or nothing even have fellowships. But if I’m not like if I’m a cosmetic dentist or esthetic dentist, of course, boom.
17:58 – 18:05
Alex Nottingham JD MBA
A.C.T. But what if I’m a general? Dennis Who is a right fit to be a member of the A.C.T.?
18:06 – 18:40
Mike DiFrisco
Yeah, I love that question because we talk about it all the time. I mean, ACD is not for not for everybody. It’s for those practitioners who have a fire in their belly to do kind of excellent work all the time. They want to they want to raise the bar. They want to provide excellent patient results. And I heard one accredited fellow say that when they’re dealing with a patient, they want to be they want to supply perfection in the end result, but they’ll settle for excellence.
18:41 – 19:02
Mike DiFrisco
And I thought that was kind of a neat way to say, you know, look, I need the training. I need to understand materials and methods. I need to understand, you know, clinical best practices. And once I understand that better, I can provide better patient results. And, you know, accreditation is an option if you want to go through the process of of credentialing.
19:02 – 19:29
Mike DiFrisco
And we, like I said in the in the context of the survey that our accredited members, their practices average almost 1.5 million in annual revenues compared to 1.3 million for general members and nonmembers, about 850,000. So you can see there’s quite a delta there once those clinical skills are elevated to the point where you’re providing excellent patient results.
19:29 – 19:41
Mike DiFrisco
So there’s definitely a monetary advantage to being affiliated with the academy as well. So that’s the story that that that this survey has told us year over year.
19:42 – 20:11
Alex Nottingham JD MBA
Well, Michael Driscoll, the CMO, the chief marketing officer of the American Academy of Cosmetic Dentistry, the AICD, thank you so much for being on the podcast. Well, please follow us on Apple Podcasts, Spotify and YouTube. And this way you’ll get the episodes as they are released and share with your friends together. Let’s continue to make a difference in dentistry and until next time, go out there and be an all star.
