Leadership, Technology & Trends in Dentistry: A Conversation with Dr. Bradley Dykstra

In this episode, Dr. Bradley Dykstra, CEO of MI Smiles Dental Group, shares insights on dental industry trends, the impact of technology like AI and virtual agents, and how strong leadership, culture, and data-driven decisions are key to navigating staffing shortages and economic shifts.

Episode Transcript

(00:00):
Running a DSO means balancing patient care with
smart financial solutions.
But what if you could increase treatment acceptance
rates without adding financial stress for your patients?
Splitit provides a frictionless installment solution that lets
patients pay over time using their existing credit
cards with zero added interest.

(00:20):
No applications,
no new loans, just a simple way to
make high quality care more accessible.
Your practice gets paid upfront, patients enjoy stress
free payments, and you build long term loyalty,
all while reducing barriers to treatment.
Ready to transform your payment experience?
Visit splitit.com/beckers

(00:41):
to learn more, and start offering flexible payments
today.
Hello. This is Cameron Cortejano with the Becker's
Dental and DSR review podcast.
I'm thrilled to be joined today by doctor
Bradley Dykstra, who is the CEO at MiSmiles
Dental Group.
Doctor Dykstra, thank you so much for being
here today. It's my pleasure, Cameron. Great. To

(01:01):
just start us off today, can you introduce
yourself and tell us a little bit about
your background?
Yeah. Okay. I'm Bradley Dykstra. I got my
DDS from the University of Michigan, go blue,
many,
many years ago.
I have not been at the chair for
five years now,
but I'm still actively involved in the management

(01:22):
side of our organization.
And we're a small
doctor owned, doctor led
DSO
in Western Michigan,
generally the Greater Grand Rapids, Michigan area,
which is a great city, and it's becoming
more and more famous throughout The United States.
So that's good.

(01:44):
And, also, several years back, I did go,
and I did get my
MBA.
And as far as our organization,
again, we do have certain things centralized. Most
of our RCM is centralized. Our HR is
centralized.
Our call center is centralized.
And, also, we have a cloud based software

(02:04):
which makes
keeping tabs on all the doctors and everything
great, and it allows them to interact even
from different offices. So that's a little bit
about who we are.
Awesome. Thanks so much.
What are some of the biggest issues
that you're currently following in the dental industry
as we're a couple months into 2025.

(02:25):
So what trends have you kinda seen so
far, and what are you kinda looking at
for the rest of the year?
Okay. Well, a couple things are
I continue to follow, and that's kind of
the reimbursements
rates,
the
consolidation
trend that seems to be continuing.
And I guess in one sense,

(02:46):
if it gets too big and some of
the big DSOs get
too big, I just
that concerns me that they may have too
much influence
in the whole dental world. But I think
we're a long ways from that, but that
is a concern.
I'm following also a lot of the states
are adding more reciprocity
between dentists. I think that's a good thing.

(03:08):
The other issues that I'm following is I
know there's talk of increasing hygiene capacity. They
are putting up new dental schools to produce
more dentists,
which we direly need.
And I think the other issue I think
that's just definitely
in the last couple months is
the consumer
confidence
in our country seems to be taking a

(03:30):
hit.
And so I'm sort of watching that. We
have not seen an effect on patient flow
or treatment acceptance yet,
but that is something we're really paying close,
close attention to.
And as always, again, with reimbursements
not going up to with the cost of
labor and all of our other costs,

(03:52):
the profit squeeze is something we have to
not forget about.
Yeah. Absolutely.
So when you talk about this consolidation,
continuance of that in the DSO space
and and, you know, the big DSOs and
big groups getting bigger,
what do you kinda see for maybe, like,
a timeline of, like, how these big DSOs

(04:14):
will really
set themselves apart in just terms of sheer
size from from some of the other practices
and
kind of what you might think could cause
that continued consolidation
going forward?
I think when, you know, when they get
a certain size, I think they are able
to

(04:35):
provide,
I'll say, better learning opportunities
for the dentist,
maybe have more structured program, just programs because
of their size.
And and, again, I'm not saying they're there
now. And I think with
the current economic environment,
I don't see
any huge mega mergers

(04:56):
on the horizon.
But it's just something that it's kind of
out there. It may or may not happen.
So I do not have a crystal ball,
Cameron, but,
I mean, I like the fact
okay. We're a small group, dentist owned, dentist
led,
and so we can still keep the the

(05:17):
family atmosphere,
everything else, you know, sort of like the
independent
family practice,
except we have
a little bit of size, which does
allow us to centralize a few things, get
some cost savings in certain areas.
But, again, not the cost savings that the
really big ones can get. And, again, that

(05:40):
puts everybody else at a little bit disadvantage.
But
that that that's the American way in capitalism,
so
we just have to be aware of it
and pick our pick our lane.
Right. That makes a lot of sense.
Something that I'm curious to get your thoughts
about are what are some things that you're

(06:01):
most excited about when it comes to dentistry
right now, and what are some things that
are potentially
making you nervous about the industry?
Well, there's
technology has always been
on my front burner for all of these
years, which has really kept me involved and
interested in dentistry.

(06:21):
I've had the opportunity
in
earlier years to be really instrumental in speaking
on digital radiography, intraoral photography,
scanners, lasers, all that good stuff.
But right now, it's all in
AI. I mean, just
in addition
to what AI can do in the treatment

(06:41):
room,
that's just really, really
awesome that we happen to use Pearl. I
don't know if we're supposed to use trade
names or not, but we use Pearl with
our CareStack, and it works really, really well.
So that is great. But what I'm really
what we're
looking at now and we're hoping it arrives
sooner than later

(07:03):
is instead of having just chatbots that we
can use for certain things,
but more into the real virtual agents that
can really answer the phone and do a
lot of things that will free up our
team members to spend time with what only
real people can do, which is relating to
the people in the office,

(07:25):
servicing them, and doing their treatment.
So,
you know, virtual agents, and the other is
basically
RCM automation.
With the technology available today, there's no reason
that things have to be as complex as
they are.

(07:46):
So I'm looking for this year. I'm really
excited
because I think we'll see a lot of
advances
in the next
nine to twelve months in in that whole
area.
So that's really what I'm excited about. And,
also,
you know, something we started using last year,
and that's Securonaut. It's a way
if there's incipient

(08:07):
curious lesions instead of, well, we'll watch it,
and if it gets bigger, we'll treat it.
Now we have a positive step we can
take
and not always, but many times to arrest
or reverse
the demineralization,
which really then
gives a patient a good service.

(08:29):
So instead of we have an option other
than just watching. We actually have something positive
we can do. So I I've I'm really
positive about that. And I think in the
whole area of periodontal disease,
I do believe there's
a few things happening in that arena that
I think will make our
our job more

(08:51):
patient
specific as opposed to just
everybody the same.
So that's kind of what I'm excited about.
I'm not sure anything makes me nervous at
this point. It's more things
like we talked about issues that we're following
or that we're monitoring.
But one is the aging of the dental

(09:12):
workforce. I mean, many of the hygienists have
already retired in the next five or six
years. Probably a lot more will.
And the same with dentists. There's
a lot of dentists that are
just retiring or thinking of it in the
next couple years.
And the young ones,
there aren't quite enough of them to take

(09:33):
everyone's place yet. So that's the other thing.
And
the other thing that's
big unknown again right now is
what are the effects of the potential tariffs
on
our costs of
supplies, materials, equipment?
And
so that that whole area and, again, that

(09:55):
ties in with the consumer confidence going down.
So I think the tariffs and consumer confidence
maybe is
thing I'm concerned about the most.
And, also,
you know, the the power the insurance companies
seem to have yet,
I guess,
that that's not a positive in my book.

(10:16):
I know there are a few inroads starting
to to help the dental world out in
that regard, but we've got a long ways
to go.
Got it.
When it comes to those shortages of of
dentists and hygienists,
is it mainly just due to, you know,
less
graduates from dental and dental hygiene programs, or,

(10:40):
is there maybe something else behind it?
I would say it's multifactorial.
COVID had an initial
effect that we haven't fully recovered from yet.
And I think especially in the hygiene world,
I think it's
not so cost effective
for institutions

(11:00):
to
educate dental hygienists.
And
even if they wanted to increase their enrollment
enrollment, they would need more instructors, which are
in short supply. So
I'm not sure all of the reasons.
And and the other thing that we've noticed
in the in the hygiene world, and
we're not sitting too bad. We have

(11:21):
most most of the number of hygienists we
need, but we do use
basically subs
probably
every day in a few of our offices.
And we're finding a lot of the hygienists
now, they like to just
kinda sub go from office to office so
they're they can work if they want, not
if they want. So it gives them real

(11:42):
flexibility.
They tend to charge quite a bit. So,
you know, that is what it is,
but I don't have the specific answer. All
I have is some vague ideas.
Got it. Thanks.
And then just the last question
that we have today. In your opinion, what
will the most effective health care leaders need

(12:04):
in order to be successful in the next
two to three years?
A few things. Number one,
don't panic no matter what's going on you.
Remain calm.
Stay in your bubble, we would call it.
If there's something outside of your control,
don't worry about it. Only focus on things
in your control.

(12:25):
And, again, no matter what happens,
keep your ultimate vision in front of you
and in front of the team so we
know why we're doing what we do.
And, again, stick to your core values when
you're making your decisions. Whatever you do, if
you have your core values,
stick to them,

(12:45):
and
don't waiver just because of
certain economic conditions at any given time.
And as always,
really pay attention to
the culture in your office and
really understand your numbers, understand your KPIs,

(13:07):
and
delegate everything that you possibly
can
effectively.
That does doesn't mean just give it to
somebody, but
help them learn it, do it, inspect what
you expect,
and really use
KPIs,
use numbers,

(13:27):
understand your numbers, and pay attention to them
and use them. Because if you don't, you'll
get
you won't be successful.
Awesome. Thanks. Yeah. I think those are some
great things, for for leaders to keep in
mind,
going forward, especially with some uncertainty
in the dental space at least.
So thanks

(13:48):
a lot. Really appreciate those those thoughts.
Well, you're so welcome, Cameron.
Well, thank you for joining us today, doctor
Dykstra, and sharing your valuable expertise and insights
into the dental space and in the industry.
It's been a pleasure speaking with you, and
I look forward to connecting with you again
in the future. Alright. I'll look forward to

(14:08):
it too, and you have a great day.
Thanks. You too.