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Office Visit: Dr. Stevie Ames Roberts by Kyle Patton, associate editor

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Categories: Practice Management, HR and Accounting;
Office Visit: Dr. Stevie Ames Roberts 

by Kyle Patton
photography by John Vicory

Dentists spend most of their working hours inside their own practices, so they usually don’t get many opportunities to see what it’s like inside another doctor’s office. Dentaltown’s recurring Office Visit profile offers a chance for Townies to meet their peers, hear their stories and get a sense of how they practice.
Plenty of future dentists grew up around a practice, but not many grew up above one. Dr. Stevie Ames Roberts’ childhood home was a Philadelphia brownstone in which her parents practiced dentistry on the first two floors. Following in her folks’ footsteps, this Townie would go on to a master’s degree in biomedical science before taking on dental school. After practicing alongside her parents for a few years, Roberts and her husband (also a dentist!) headed west to the Seattle metro area, where she worked as an associate at the practice she now owns.

In our exclusive Q&A, she walks us through the transition from employee to owner, breaks down how to strike a balance between high-tech and homestyle, explains how she developed a new brand of toothpaste tablets and more.
Stevie Roberts Interview
How’d you find your way into dentistry?

Well, I grew up in a dental office. My parents are both dentists, and for most of their career, their primary practice was the first two floors of our family home on Rittenhouse Square in Philadelphia. It was (and still is) a beautiful way to practice and live. Their staff is truly family, which, even though my home and practice are separate these days, is an important part of the culture at my practice, Dentiste, too.

Even though I was surrounded by dentistry growing up, I never thought I would become a dentist. I explored several other careers, including medicine, and in doing so truly came to appreciate what my parents built and how dentistry enabled them to build careers and lifestyles that embrace patient care, family and community.


Tell us about your first year in practice.

Right after dental school, I was fortunate enough to move back home to Philly and practice with my parents. They have two practices—the one in our family home is a boutique practice, similar to Dentiste, called Philly Smiles, and the other is a larger, multispecialty practice called Dentists on the Square. Working for my parents in two distinct practices made it possible for me to learn from specialists and other experienced doctors to further my dental education and hone in on what I wanted my future practice model to be.

I loved being back in Philly with my family. But I also love my now husband, who had started an oral surgery residency in Seattle right after school, and so, after a little more than a year in Philly and managing a long-distance relationship, I moved across the country. It was February 2020 and the first case of COVID-19 in the U.S. was announced in Kirkland, Washington, in March 2020. Obviously, it was not a great time to be looking for a job as a dentist, so like almost everyone else in the profession I had a few months off from work.

Finally, I found Dentiste. I was fortunate enough to work at Dentiste as an associate for a year before I took over. It was a unique situation because the owner and founder had moved several hours away a few years previously and worked in the office clinically only a couple days each month. That gave me the opportunity to be the lead dentist in the office and to manage a team without also having to run the business. It also made the transition much smoother when I did purchase the practice, and meant I felt confident that I knew as much as I could about what I was getting myself into.
Office Highlights
NAME:
Dr. Stevie Ames Roberts

GRADUATED FROM:
Tufts University

PRACTICE:
Dentiste
Kirkland, Washington

PRACTICE SIZE:
1,400 square feet;
4 operatories

TEAM SIZE:
8

What changes have you made?

When I first took over, our team was exceptionally skilled in their roles but too lean. I ended up hiring two new people who had never worked in dentistry before and investing in their training and potential. The first role was in the back, starting as a circulator tasked with things like flipping rooms, seating patients, sterilizing instruments and generally supporting my lead dental assistant. Since then, she has taken a lot of initiative and is now working chairside and taking on more and more responsibility.

The other role was at the front. She started with scheduling, greeting patients and collecting payment. Because she hadn’t worked in dentistry before, it was a big learning curve to grasp insurance, payments and certainly all the dental jargon. She has also come a long way and, if anything, she keeps me working too hard with scheduling.

These two members of the team have become integral to how the practice functions and cares for patients, and it has been really rewarding to watch them thrive and grow in their new roles.


What’s the most difficult part of transitioning from associate to owner?

You have to accept that you won’t know everything and that you will stumble. Build a team and support system around you so you know where to go for answers—or at least people you think will understand the questions. That includes a support system of staff and friends who have gone through practice transitions; lawyers and accountants who specialize in dentistry; and anyone else dentists you know would recommend. It’s OK if everything doesn’t go smoothly at first. As long as you do right by your patients and the people you work with, you’ll be successful.

I would also recommend not getting too caught up in the numbers at first. You should of course do your due diligence with the help of a dental accountant before buying a practice to make sure it’s a smart investment, but then don’t be afraid to let the numbers take a back seat while you settle into your new role as owner. Invest in people and things that improve patient care and make sure to prioritize your health and sanity—which includes taking time off to enjoy life outside of the office.

Now that I’m in my second year of ownership, I have brought a new focus to the numbers to improve financial efficiencies, which has been rewarding. It takes at least a year to have enough data to make smart financial decisions


Part of the new practice involved a rebrand. How’d you go about it? What did you change?

I was fortunate that the owner before me put a lot of thought and effort into the Dentiste brand before I took over, but it was time to make it my own. One of my best friends from Philly had previously helped build the brand of a toothpaste company I co-founded—more on that later!—so I knew right where to go when it came to do a rebrand. We kept the name Dentiste and redesigned the logo and color palette.

I think it’s important to not jump into a rebrand too early, and to really get a feel for what your personal brand is before consulting a designer to pursue what you want to convey to your community and patients. And on that note, I would definitely recommend consulting a designer. As dentists, especially practice owners, we often feel like we can or should do everything ourselves, but it’s also important to know when to bring in the professionals.

I also shared the design process with my staff, which made it personal for everyone. They have really bought into the new brand and were quick to have new signs made!


Let’s talk about the real star of the office: your dog, JoJo. Tell us about her and how she became such an integral part of the practice.

JoJo is a rescue dog from Georgia. She is about 5 years old now and was rescued from a high-kill shelter in the South by two of my best friends. She didn’t come to the office when I was an associate, but I knew I wanted to change that as soon as possible.

At first, I was worried about how patients would react, but now I get more complaints on the occasional day JoJo isn’t at work than anytime else. Patient reception has been overwhelmingly positive. She not only gets patients excited to come to the dentist—which we all know how hard that can be!—but she also truly puts people at ease, especially when they’re in the chair. It’s common to see a patient with their left hand hanging off the chair petting JoJo while I’m doing a procedure


For docs out there who might feel a bit of envy, what can they do to get their dogs into the office safely and in a way that benefits the practice?

We made a sign outside our front door that explains JoJo is in the office to help with dental anxiety, but anyone who’s allergic or would not like to be greeted by JoJo should call and let the front desk know. Truth be told, even the few patients who ask not to be greeted by her eventually end up asking about her and getting a few belly rubs in!

I would say, “Don’t overthink it, but be conscientious.” We benefit from working in a dog-friendly community, and JoJo has a temperament that works in the office. I think you know in your gut if it’s appropriate to bring your dog to work, and if your gut says yes, then at least try!


You’re known for working well with challenging patients. What’s the most important chairside quality?

I practice in Kirkland, an affluent community just outside of Seattle that’s filled with interesting and successful people. That also means many of my patients are used to being in positions of power and control in their professional lives, which can be hard to surrender in the dental chair.

I am also a terrible dental patient and understand the vulnerability patients experience. Acknowledging their circumstance is a huge first step. It’s easy to forget as a provider because it is our everyday, but it’s a privilege to treat patients, and it’s important to remind yourself of the trust your patients are placing in your hands and to act accordingly. A patient-provider relationship of trust will go a long way. Sprinkle in a little nitrous and a therapy dog, and you’ll be unstoppable.


Top Products
DUO TOOTHPASTE
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ITERO INTRAORAL SCANNER
All new patients get an iTero scan at their first visit, which establishes a dental baseline, helps communicate any recommended treatment and generally impresses patients with the technology we offer. I also use iTero for Invisalign and prosthodontics and have found it to be incredibly accurate and reliable.

SDR FLOW+ BULK-FILL FLOWABLE COMPOSITE (DENTSPLY SIRONA)
I like SDR Flow+ bulk-fill composite because it has a weighted component that seals the floor of the box of my interproximal posterior fillings.

TETRIC EVOFLOW COMPOSITE (IVOCLAR)
Tetric EvoFlow is my favorite flowable composite for anterior bondings. I like that I can custommix a variety of shades right on the tooth and it looks great with texture or highly polished.

3M ASTRINGENT RETRACTION PASTE
Although there are still some indications for traditional cord, this paste stops bleeding quickly and dries the tissue for a better scan, making crown prep appointments more efficient. It also does not contain aluminum chloride like other hemostatic agents, so it doesn’t stain ceramic restorations.
You’ve invented your own toothpaste! Walk us through the history of this endeavor.

It has been an incredible journey co-founding Duo Toothpaste with my husband and two best friends! Duo is a tablet toothpaste that comes in recyclable, refillable glass bottles and compostable refill envelopes. You chew the tablets, brush and spit just like a traditional paste, but with only clean ingredients that optimize oral health and without plastic waste.

The statistics are alarming: Only half of Americans brush their teeth twice a day, and most spend only 45 seconds brushing. My patients struggle as well and I treat the consequences, so we created Duo to help people fall in love with brushing their teeth. As a dentist, I’m driven to make brushing more exciting and worthwhile so people brush for longer, consistently.

The next few months were spent researching all things toothpaste, which led to us purchasing an industrial pill press and conducting hundreds of trials in our garage.

Our research was exhaustive; we made formulating the best tablet toothpaste for oral health our top priority and then took it to the next level with bespoke flavors, luscious foam and functional ingredients that utilize mucosal absorption to bridge the gap between oral health and systemic wellness. After 18 months of trials and gathering feedback while also working on Duo’s brand and operations, we found the right partner to produce our tablets at scale, and our toothpaste is now available on our website and through select dental offices.

The response from consumers and the dental community has been overwhelmingly enthusiastic and we could not be more excited for what’s to come.


What’s a typical patient experience like in your office?

 The first thing they experience is JoJo racing to the front to greet whomever just walked through the door. That definitely sets the tone. Our reception area is designed to be inviting and not give the traditional feel of a waiting room: We splurge on fresh flowers and candles with carefully curated scents and take pride in our playlists. The office has large windows that bring in natural light and views of all the surrounding greenery. The result is a reception area that looks, sounds, smells and feels more like a home than a dental office.

It’s also important to us that patients spend as little time waiting as possible, so we quickly get them seated in the back.

All new patients get an iTero scan even before I see them. We do this to establish a baseline scan, which both communicates to the patient that we plan to take care of them long term and shows off our technology. Many of my patients are in the tech industry and find the iTero as impressive as it is useful. And even for those who aren’t in tech, everyone in our office appreciates the lack of traditional, goopy impressions.

Patients love attention, and we make sure they get plenty of it. They are rarely in an operatory without someone else. My team is incredible and keeps the process efficient for both me and the patient, which doesn’t go unnoticed.


You’ve done plenty of cosmetic cases. What are some practical tips you’ve picked up?

First off, I almost only do cosmetic cases with patients who come to me for that reason—in other words, I don’t recommend cosmetic treatment to patients, but once that conversation starts, I will recommend how many teeth should be involved, and usually eight is better than six for the best result. I also make sure patients don’t rush into cosmetics; I have them go home and come back another time before agreeing to start a case. I also recommend starting with whitening— many times that’s enough, and if it isn’t, it will set you up for success when it comes time to find a shade.

When indicated, it’s great to do a round of Invisalign before veneers to space the teeth you’re working on for more conservative preps and less drilling. It also means you can control the bite, which ensures better long-term success of the restorations.

Find a lab tech—not just the lab— to work with and spend the money to get the best person possible. It’s worth it for you and the patient


What cosmetic products would you not practice without?

Invisalign and the pairing of KöR whitening and Opalescence Go whitening are important to my practice and patients, for a few reasons.

From a business perspective, these are great services to offer patients that are unique in dentistry in that they don’t require the use of a handpiece or needle. That’s nice because it’s helpful to have a source of production that isn’t physically demanding and helps to break up a schedule of procedures with what I like to call a “clipboard” visit: Everyone wins because it gives you a chance to check in with your patients in a more casual visit setting, which also makes patients more comfortable spending time in your office knowing they won’t be poked and prodded.

The previous owner of Dentiste had also offered Invisalign and was gracious in training me. Invisalign offers a great support system as well as continuing education. The most important aspect of your treatment plan is your deep understanding of occlusion. I really enjoy the treatment-planning process, and it’s rewarding to watch people’s bites and smiles fundamentally change over time. Invisalign has also been a great source of new patients. I have many new patients who come to me with the chief complaint of specifically wanting Invisalign before a wedding or just because they spend so much time analyzing their own smiles during online meetings.

I offer KöR in-office whitening for my patients who are willing to spend the money and time in the office for the best possible whitening results. For patients who would rather whiten at home or try a more affordable option first, I also offer Opalescence Go. This pairing compliments each other well and ensures that my patients can get the whitening experience that works best for them. Just because whitening is “easy” doesn’t mean it should be overlooked in your practice!


What kind of cases excite you the most?

I find a lot of pride in taking in new patients who have been looking for a dental home but haven’t found somewhere that makes them feel comfortable addressing their dental needs.

It doesn’t matter if they only need to get twice-annual cleanings or if they need a lot of work done because for years they haven’t been able to find a dentist who fits them. The most important thing and what drives me is to make them feel cared for and confident that they’re receiving the best care possible.

Of course, the more treatment they need, the more effort that goes into their care and the more rewarding the outcome, which gets me excited. Those patients are also exciting because by the time you get them to a new baseline, you and your team and the patient have spent a lot of time together, which makes for a unique bond.


What’s a trend in the profession you’re not crazy about?

This is probably all too common of an answer, but the pressure from insurance companies is definitely not something I’m crazy about for myself, my patients or the profession. I believe as an industry we have to work toward a more fair and efficient system.

I am currently in-network with only one insurance company, which I’m in the process of reconsidering. I’m fortunate to work in an area where that’s possible, but it was by design that I purchased a smaller practice that does well with a relatively low volume of patients.

Of course, while that was a business decision, as a doctor and someone who cares deeply about making care accessible, I always work with patients to make sure they get the treatments they need. I reduce rates in certain cases and offer no-interest payment plans.


What’s your most controversial opinion in dentistry?

There’s still a widely held belief that fluoride is the only means we have to remineralize teeth. To be sure, fluoride has done amazing things for dental health, but there is also nano-hydroxyapatite (nHA), which was developed by NASA in 1970 to help astronauts who experience mineral loss. Since then, it’s become the standard of care in Japanese oral care, with growing popularity in Europe and the United States.

We have decades of high-quality literature that proves nHA is as effective as fluoride at remineralizing enamel and dentin—many studies actually show it is more effective. It also physiologically whitens teeth without peroxides; it plugs dentinal tubules; it prevents hydrodynamic pressure on dental pulp, thereby treating sensitivity at the source; and it prevents plaque accumulation as effectively as chlorhexidine without being caustic to the oral microbiome.

In dental school, we all learned about nHA for bone augmentation, but it’s now being introduced in curricula as a remineralizing agent.

We are proud to use nHA in Duo toothpaste and to offer a fluoride alternative that is just as effective with many additional benefits.


What initiative in your practice are you proud of?

Reducing plastic waste! It is a huge issue in health care in general and can be difficult to overcome, especially given all the plastic materials that are used to maintain safe sanitary practices. We stopped using plastic disposable air-water syringes and suctions, and are always on the lookout for other ways to reduce our single-use plastic consumption.

Helping patients reduce their single-use plastic is also a huge point of pride in our development of Duo Toothpaste, which comes in recyclable and reusable glass jars and ships toothpaste tablet refills in compostable envelopes. Traditional plastic tubes of toothpaste take 500 years to biodegrade in landfills, meaning every tube of paste you have ever used will outlast you. That’s crazy to think about, and completely avoidable!


Give us a snapshot of your life outside of dentistry.

Even though I practice in a suburb, I’m a city kid at heart. My husband and I live with JoJo in Seattle. Dentistry keeps us busy because of Dentiste, his oral surgery residency and working on Duo. We make sure to spend as much time with friends and family as possible. (It helps that we co-founded Duo with our two best friends, so every meeting is also a hangout.)

When I moved out to Seattle just in time for COVID-19 to hit, my husband was in the medical school portion of his training and also ended up with several weeks off. We took that time to buy a small cargo trailer we built out to be a camper-trailer. During the COVID-19 shutdown, we made the trip all the way to the East Coast and back with the trailer, and since then it has been our escape pod for when we really want to unplug and explore.

Once you’re in, you’re never truly outside of dentistry. It’s a part of you—and for that we are grateful.
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