Painful start-up lessons

May 2, 2019
Chris Salierno, DDS, Chief Dental Officer, Tend

I took a sip of my coffee and continued rambling about my frustrations as an employee dentist. The young dentist sitting across from me listened intently, and then chimed in with her own experiences. Sure, a lot of new dentists meet up and swap war stories about being an associate, but this was more than just a gripe session; it was the start of a business.

Almost exactly 10 years ago, I sat down at a local Starbucks with my potential future business partner, Erin Thomas, DMD. We had both been playing “associate musical chairs” but had yet to find our own seats when the music had stopped. Rather than continue searching for another existing opportunity, we had both become captivated by the notion that we could create our own. We were seriously considering a start-up dental practice in an area saturated with dentists, in the wake of the Great Recession.

Despite the odds, it worked. We built our practice from scratch and are still alive to tell the tale. Our past decade in business together has taught us many lessons, often painful ones. We’ve learned that throwing money at marketing without a plan is often a waste. We’ve learned that holding on to toxic employees is more traumatic than firing them. But the important thing is that we learned. We failed our way to success, just like every other successful business owner.

Start-up dental practices don’t have existing patients already scheduled for hygiene, tried-and-true systems, or trained team members; they’re a blank canvas. Those of us who choose this path to practice ownership shouldn’t feel overwhelmed by the potential mistakes; we should feel liberated by the possibilities.

In this issue, Amisha Singh, DDS, and Jason Watts, DMD, share their insights into start-ups, while Xaña Winans provides a timeline to ramp up marketing. I hope that these articles will shorten your learning curve.

That day in the coffee shop, after discussing our favorite and least favorite associate jobs, Erin and I had the very beginnings of a business plan. We were years away from having a waiting list for hygiene appointments or from figuring out how to handle accounts receivable. Those things came along eventually. What we did have was a shared vision for what the practice of our dreams might look like and an appointment in our calendars to meet again.


Chris Salierno, DDS

[email protected]

About the Author

Chris Salierno, DDS | Chief Dental Officer, Tend

Chris Salierno, DDS, is a general dentist from Long Island, New York. He graduated from Stony Brook School of Dental Medicine in 2005. Dr. Salierno lectures internationally on clinical dentistry, practice management, and leadership development. In 2017 he became a chief development officer with the Cellerant Consulting Group, and he was the chief editor of Dental Economics from 2014 to 2021. In 2021, he became the chief dental officer at Tend. He can be reached on Instagram @the_curious_dentist.

Updated May 13, 2022

Sponsored Recommendations

Clinical Study: OraCare Reduced Probing Depths 4450% Better than Brushing Alone

Good oral hygiene is essential to preserving gum health. In this study the improvements seen were statistically superior at reducing pocket depth than brushing alone (control ...

Clincial Study: OraCare Proven to Improve Gingival Health by 604% in just a 6 Week Period

A new clinical study reveals how OraCare showed improvement in the whole mouth as bleeding, plaque reduction, interproximal sites, and probing depths were all evaluated. All areas...

Chlorine Dioxide Efficacy Against Pathogens and How it Compares to Chlorhexidine

Explore our library of studies to learn about the historical application of chlorine dioxide, efficacy against pathogens, how it compares to chlorhexidine and more.

Enhancing Your Practice Growth with Chairside Milling

When practice growth and predictability matter...Get more output with less input discover chairside milling.