Group Function: Decoding DSOs with Dr. Mark Costes & Dr. Paul Etchison
The Very Dental Podcast Network
Release Date: 07/31/2026
Very Clinical: Getting Ahead of It, part 2: Everyday Operative
The Very Dental Podcast Network
Kevin and Zach welcome back Alan to dive into the art of "getting ahead of it" in everyday operative dentistry to prevent patient complaints before they start . From anticipating shade discrepancies caused by tooth dehydration during anterior composite restorations to managing lingual thickness and opposing occlusal contacts, the conversation breaks down real-world restorative hurdles . The team discusses the critical value of clinical photography for documenting chipped incisal edges, strategies for placing rubber dams and anatomical wedges (or "separators") without startling patients,...
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Very Dental: The Art of Longevity with Dr. Marco Maiolino
The Very Dental Podcast Network
Alan is joined by Dr. Marco Maiolino live from the 2026 Bioclear Summit to challenge the profession's obsession with superficial aesthetics and make the definitive case for longevity dentistry. Drawing on over two decades of clinical experience in Sicily, Marco breaks down the psychological nuances of real informed consent and how clinicians must take clinical responsibility to remove doubt. He outlines his pragmatic, stepped protocol for treating worn dentition using Smile Cloud, aesthetic mock-ups, and reversible snap-on PMMA "rebalances" to open vertical dimension without irreversible prep...
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Very Clinical: Getting Ahead of It, part 1: Anesthesia and Occlusion
The Very Dental Podcast Network
In this episode of the "Getting Ahead of It" series, Zach, Kevin, and guest Dr. Alan Mead break down practical communication strategies to preempt patient complaints and callbacks before they happen. Starting with local anesthesia, the trio covers common chairside dilemmas: setting realistic expectations between upper and lower numbness, handling palatal pressure, navigating anatomical misses, managing epinephrine-induced jitters, and managing the dreaded numb-eyelid sensation. The discussion shifts to post-op occlusion, exploring why asking numb patients "how does your bite feel?" often...
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AME: Radical Consent and the Lost Art of Tooth Preservation
The Very Dental Podcast Network
Fresh from the 2026 Bioclear Alumni Summit, Alan reflects on the power of tooth preservation, the lost art of "herodontics," and why the default move to implant therapy might be selling patients short . Addressing recent listener feedback about network reruns and solo monologues, Alan dives into standout presentations from Dr. Rafael Bustamante and Dr. Marco Maiolino that challenged conventional treatment planning and reexamined the true meaning of radical informed consent . Rather than viewing heroic restorative efforts as subpar dentistry, this episode explores how well-engineered, minimally...
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Very Dental: A New Twist on Dental Instruments with Kyle Lim of Power Dental Group
The Very Dental Podcast Network
Alan welcomes Kyle Lim, the dynamic owner of Power Dental Group, to discuss how a second-generation family sharpening and retipping business evolved into a disruptive direct-to-dentist brand. Kyle pulls back the curtain on taking over his father’s blue-collar manufacturing roots, shifting away from declining trade shows, and leveraging engaging social media marketing to stand out in a historically sterile industry. Along the way, the two dive into practical problem-solving in the operator including patented innovations like the Power Crown Remover for tackling stubborn zirconia, the...
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Very Dental Classics: The Implant Pathway Story with Dr. Justin Moody
The Very Dental Podcast Network
In this throwback episode Dr. Justin Moody joins Alan to chronicle the remarkable evolution of Implant Pathway—from early hotel seminars to establishing a massive, purpose-built 32-operatory clinical training and nonprofit center in Scottsdale . Together, they break down the philosophy of the Fast Track program, emphasizing actionable clinical judgment, live-patient mentorship, and the importance of immediate chairside implementation . The conversation also covers the regulatory landscape of Arizona’s Good Samaritan temporary dental licenses, Dr. Moody’s newest venture into winemaking...
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AME: Is Podcasting Dead?
The Very Dental Podcast Network
Alan reflects on the stark contrast between social media reach and traditional audio podcast listenership after short Instagram clips featuring guest Dr. Brady Smith quickly garnered tens of thousands of views while overall podcast downloads remained steady . Looking back on the evolution of dental media since co-founding The Dental Hacks in 2014, he examines the rise of short-form video, shifts in podcast download metrics, the role of algorithmic distribution compared to RSS feeds, and whether traditional audio shows can still effectively connect with dental professionals . We're proud to be...
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Very Dental: 18 Board Complaints and Selling Out Comedy Clubs with Dr. Brady Smith
The Very Dental Podcast Network
What happens when you combine an aggressive 16-hour clinical shift, 18 frivolous state dental board investigations, and a completely fabricated, highly inappropriate anesthesia technique? You get Dr. Brady Smith’s return to the Very Dental Podcast. Alan sits down with Brady to unpack his transition from a dentist who merely likes attention to a full-blown social media juggernaut. Brady explains why he’d gladly accept a shout-out from anyone with a pulse, confesses to "bone smashing" exclusively during lower molar extractions, and recounts how an absurd viral bit called the "fireman's...
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Very Dental Classics: The Legacy of the Vedder Society
The Very Dental Podcast Network
In this throwback episode, the Dental Hacks (Alan and Jason) kick things off by breaking down the realities of practice build-outs, avoiding the dreaded “construction valley,” and weathering economic downturns before revisiting a milestone live recording from northern Michigan . Recorded on location at the 60th anniversary celebration of the Francis B. Vedder Society, Alan passes the microphone to longtime members, prosthodontic mentors, and dental technicians to reflect on six decades of clinical excellence . From legendary clinician encounters—including early lectures from Dr. Frank...
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AME: Different Sports
The Very Dental Podcast Network
Fresh off his annual trip north for the Francis B. Vedder Society meeting, Alan dives into the notorious dental slump known as “Sucktember” and unpacks the clinical disconnect many general practitioners feel during high-end continuing education . While watching master-level prosthodontists and technicians showcase complex, full-arch All-on-X cases is inspiring, Alan argues that comparing everyday general dentistry to full-mouth reconstruction is like comparing hockey to the long jump—they are simply entirely different sports . From mountain biking through Glacial Hills to reflecting on...
info_outlineIn this throwback episode of the Group Function Podcast, Alan Mead sits down with two titans of dental podcasting: Dr. Mark Costes and Dr. Paul Etchison! Together they decode the rapidly evolving world of Dental Service Organizations (DSOs). They break down complex industry jargon like EBITDA, recapitalization, and same-store growth, making it easily digestible for independent practice owners. The trio explores the transition from the initial wave of practice consolidation to the modern, highly discerning private equity landscape. Between dropping heavy business knowledge, they also take a nostalgic detour to reminisce about feral 1970s and 80s childhoods, riding bikes until sundown, and the ultimate debate: Star Wars versus He-Man.
Mark and Paul use quite a few terms that you might not be 100% familiar with. I had heard them kicked around, but before the conversation starts, I list a couple definitions that you might find helpful:
- DSO: Simply put, DSO stands for Dental Service Organization. A DSO is a company that helps administer the business aspects (management, marketing and business administration) of the dental practice.
- EBITA: EBITA stands for "Earnings Before Interest, Taxes and Amoritization." It is a measure of profitability that a potential investor can use to evaluate a potential company or practice. It's used help make "apples to apples" comparisons between potential investments. EBITA is calculated from financial data reported by a company. Many DSOs valuate dental practices as a multiple of their EBITA.
- same store growth (or same store sales): a measure of growth used by a DSO to know how well an individual practice within the DSO is doing. A DSO will want to know how well the individual practice is doing vs. the entire DSOs growth. The idea is to invest in a practice that has potential to grow in it's own location separate from its relationship to the whole DSO.
- Private equity (or PE): a type of investment where investors buy shares of privately-held businesses. Private equity is the money supply that has driven the DSO revolution in dentistry (and many other industries). Private equity money expects a return on their investment much like any investor would.
- Recapitalization (aka: recapitalization event): "the second bite at the apple" according to Mark and Paul. Recapitalization is the restructuring of a company's debt and equity mixture, and/or financing. This is usually done to stabilize a company's capital structure. In the context of a DSO, recapitalization might be the sale of a smaller DSO/group to a larger one and/or the buying out of dental owners.
Some links from the show:
- Dental Success Network (Mark's stuff)
- Dental Practice Heroes (Paul's stuff)
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