The Dr. Phil Klein Dental Podcast

How do successful fee-for-service practices thrive without insurance participation while building genuine patient relationships and maintaining profitability?
Dr. Graziano D. Giglio brings over 30 years of prosthodontic expertise to this comprehensive discussion on practice optimization. A board-certified prosthodontist and Fellow of the American College of Prosthodontists, American College of Dentists, Greater New York Academy of Dentistry, Northeastern Gnathological Society, and New York Academy of Dentistry, Dr. Giglio earned his D.D.S. and postgraduate training in prosthodontics from New York University College of Dentistry. He serves as Adjunct Clinical Associate Professor at NYU College of Dentistry and received the Prosthodontist Private Practice Award from the American College of Prosthodontists in 2013. He operates an interdisciplinary practice in New York City with his wife, Dr. Ana Giglio, a periodontist.
This episode breaks down Dr. Giglio's proven ACDC framework: Attract, Convert, Deliver, and Collect. The conversation explores how high-end practices can differentiate themselves in competitive markets, build systems that serve demanding clientele, and maintain profitability while delivering exceptional patient experiences. Dr. Giglio shares specific strategies for managing time-sensitive business professionals, converting consultations into committed patients, and implementing collection systems that support both practice sustainability and patient relationships.
Episode Highlights:
Time-sensitive patient management involves parallel processing with multiple assistants, allowing procedures like provisional fabrication and cord placement to occur simultaneously while maintaining continuous patient engagement. Business professionals are seated immediately upon arrival and checkout occurs chairside to eliminate waiting room delays.
Effective case acceptance requires comprehensive before-and-after documentation organized by procedure type in accessible digital files. Patients convert when shown specific examples of similar cases rather than generic internet images, with presentation occurring through staff-operated systems during consultation visits.
Pre-treatment financial commitments significantly reduce appointment cancellations and improve practice flow. New patients provide one-third down payment for major procedures, with full payment required before laboratory work begins, creating accountability while ensuring treatment completion.
Fee-for-service practices differentiate through user-friendly websites, immediate phone response by trained customer service staff, and comprehensive patient amenities including food service, internal restrooms, and home-like décor that contrasts with clinical sterility.
Collection systems succeed when integrated into practice culture from initial consultation through treatment completion. Staff understanding of practice financial needs translates to patient education about payment expectations, with established patients receiving more flexible arrangements than newcomers.
Perfect for: General dentists transitioning to fee-for-service models, prosthodontists and cosmetic dentists seeking to optimize patient experience, and practice owners looking to implement systematic approaches to practice growth and profitability.
Discover how systematic patient management and clear financial frameworks can transform your practice into a thriving, patient-centered operation.

How many of us are using adhesive bonding systems every single day, but don’t fully understand what’s actually happening behind the scenes? We follow the steps—we scrub, air thin, light cure… But do we really know why? And more importantly, are we adjusting based on the clinical situation in front of us? Because when we don’t fully understand adhesion, we’re probably not taking full advantage of the materials and techniques designed for specific scenarios. Today we'll dive deeper into all of this to get a better understanding of how we can optimize our bonds and minimize our failures. Our guest is Dr. Nick Marongiu. He practices full-time as a general dentist at Scripps Center for Dental Care in La Jolla, California, a comprehensive multi-specialty practice built on interdisciplinary, patient-centered care. He has a passion for cosmetic dentistry and is an accredited member of the American Academy of Cosmetic Dentistry (AACD).

In today’s episode, we’re focusing on what every dental practice can do to reduce the risk of being sued and the daily steps you can take to stay prepared—strengthen your documentation and give yourself the best chance to defend your practice if a claim arises. Our guest is Dr. Marc Goldman, a board licensed periodontist with leadership in periodontal and implant therapy. He is the founder and long-time owner of a premier periodontal practice in Millburn NJ. Dr. Goldman teaches and is a consultant on dental malpractice.

Thanks to our episode sponsors:

NSK America - https://www.nskdental.com/
BISCO - https://www.bisco.com/

In this episode, we go back to the fundamentals. We explore why the inferior alveolar nerve block fails so often, what’s really happening anatomically when patients aren’t getting numb, and how a deeper understanding of these patterns can help clinicians improve both consistency and patient comfort in everyday practice. We’ll also take a closer look at anesthetic selection—specifically the advantages of articaine over lidocaine—and discuss the clinical situations where articaine can make a meaningful difference, and why many clinicians consider it an essential part of their anesthetic armamentarium. Joining us today is Dr. David Isen. He practices in Toronto, Canada, where his anesthesia-based practice focuses on patients who require all levels of sedation, general anesthesia, and advanced local anesthetic techniques—often individuals with special medical needs, dental phobia, or unique challenges with anesthesia.

Are you still planning restorative cases by focusing primarily on individual teeth, or have you started thinking about the entire face? This fundamental shift from tooth-centered to facial-driven treatment planning represents one of the most significant changes happening in modern dentistry.
Dr. Richard Martin brings over two decades of clinical experience as an oral surgeon practicing in Lewisville, Texas since 2002. A graduate of New York University Dental School where he was elected to Omicron Kappa Epsilon and graduated with full honors in Oral Surgery, Dr. Martin completed his residency at Harlem Hospital, Columbia College of Physicians and Surgeons, where he was appointed chief resident. He furthered his training with a one-year Fellowship at the Oral Surgical Institute in Nashville. Beyond his clinical expertise, Dr. Martin is an innovator who has developed more than 20 dental instruments throughout his career.
This episode explores the revolutionary integration of 3D facial scanning technology with traditional digital workflows, demonstrating how facial scanners are transforming treatment planning from a tooth-centered approach to a comprehensive facial-driven methodology. Dr. Martin discusses how these technologies create virtual patients by merging facial scans with CBCT data and intraoral scans, fundamentally changing how dental teams approach interdisciplinary care. The conversation covers practical implementation strategies, laboratory integration, and the clinical impact on case acceptance and treatment outcomes.
Episode Highlights:
Facial scanning technology allows practitioners to capture multiple facial positions including rest, natural smile, and full retraction, providing comprehensive data sets that merge seamlessly with CBCT and intraoral scan data to create complete virtual patient avatars. This integration enables treatment planning that considers facial proportions, midlines, and anatomical relationships beyond just dental structures.
The jaw tracking feature available with certain facial scanners significantly reduces chairside adjustment time for prosthetic deliveries by capturing patient-specific movement patterns and parafunctional habits. This technology allows laboratories to fabricate restorations that require minimal occlusal adjustments, particularly beneficial for patients who are sensitive to bite discrepancies.
Intraoral photogrammetry built into modern scanners eliminates the stitching errors commonly encountered when scanning multiple implants, providing accuracy comparable to extraoral photogrammetry systems but at a fraction of the cost. This technology captures implant positions and surrounding soft tissues in a single workflow without requiring multiple file transfers.
Full arch cases, particularly those involving complete vertical collapse or edentulous situations, benefit most significantly from facial scanning technology as it provides critical reference points for establishing proper vertical dimension and facial support. The technology is equally valuable for extensive tooth-borne restorations involving multiple units in the aesthetic zone.
Successful digital workflow implementation requires comprehensive education through study clubs and online resources, close collaboration with digitally integrated laboratories, and mentorship from experienced practitioners. The transition should include maintaining analog knowledge as a foundation while gradually adopting digital technologies based on practice needs and case complexity.
Perfect for: General dentists, oral surgeons, prosthodontists, and laboratory technicians interested in integrating facial scanning technology into interdisciplinary treatment planning workflows.
Discover how facial-driven treatment planning is reshaping modern restorative dentistry and learn practical strategies for implementing these game-changing technologies in your practice.