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What 25 years at one DSO actually looks like

Published about 8 hours ago • 4 min read

When Anna Singh graduated from dental school, she had no idea what came next.
No mentor lined up. No plan for how to actually run a practice. Just a degree and a chair waiting for her at a Heartland practice.

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What changed everything was one comment from her dental assistant.
"If you can do the dentistry, I will sell the dentistry for you."
That single line reframed how Anna thought about her job. She had assumed being a great clinician was enough. It wasn't. The assistant had something Anna didn't yet have: the ability to get patients to say yes. And once Anna started paying attention to that skill, her case acceptance changed completely.

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That was the first lesson. Here's the one that stuck with me most.
Early in her career, Anna built her reputation on bread-and-butter dentistry. Not implants. Not big cosmetic cases. Crown preps. Quadrant dentistry. Getting patients out of pain. She got so efficient that a five-minute crown prep became a two-minute one, and she turned it into a game with her team, timing every procedure and challenging each other to get faster.
Twenty-five years later, she's Senior VP of Clinical Operations at Heartland Dental, overseeing clinical standards across nearly 2,000 practices.

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One thing that stood out in our conversation: most of the population has some degree of mild malocclusion, but most dentists only feel comfortable presenting aligners for the "complex" cases. Why? Because shifting a few anterior teeth doesn't feel like it's "worth" the price tag in their head.

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But that's the wrong lens. The real value isn't aesthetic. It's function. Patients who couldn't floss properly before treatment because their teeth were too crowded, finally being able to clean their own teeth after.

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That reframe (form, function, and quality of life over aesthetics) is something every dentist sitting on aligner cases should hear.

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Talk soon,

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Dr. Avi

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P.S. If this episode gave you something, send it to a dentist on your team who needs to hear it. That's how this show grows.

Video of the Week

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25 years ago Anna Singh was a new grad with no map. Today she's Senior VP of Clinical Operations at Heartland Dental, overseeing care across nearly 2,000 practices. In this episode, she breaks down the systems behind that growth: why "bread-and-butter" dentistry beats chasing big procedures, how time studies transform efficiency, why the doctor-PMO partnership makes or breaks a practice, and why radical transparency around production numbers builds stronger teams. Anna also shares the mindset shift that changed how she saw clear aligner cases—and why patient quality of life, not aesthetics, should drive the conversation.

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by Dr. Avi Patel

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