I’m sitting in a lobby so new the marble-topped cafe tables haven’t yet been bolted to the ground. There is curved green floor tile, wood-paneled walls, and brown leather banquettes to sit on. A woman behind a marble desk glows in the soft lighting as she offers to check me in. This isn’t a trendy coworking spot—it’s the dentist’s office.
Today, the dentistry startup Tend is opening its first location in Manhattan’s Flatiron neighborhood. With $36 million in funding and executives that hail from SoulCycle, One Medical, and Smile Direct Club, Tend is hoping to reinvent the dentist’s office and convince more people to care about their teeth.
The experience is designed to help you feel relaxed. Before your appointment begins, the receptionist will guide you to a room with four sinks covered in blue and green marbling, like mouth wash being swished. By this time you will have chosen one of Tend’s premium, direct-to-consumer toothpastes like RiseWell, Hello, or Marvis. They will then hand you a new Quip tooth brush and under the soft white glow of tube lights you will ceremoniously brush your teeth. The lighting, it seems, is intentionally good. “Especially nowadays, everyone loves to take that nice little selfie before they head out,” explains Ashley, the receptionist.
When you walk into your dental room, you are met with a large screen that greets you by name. Everything is white and beige. There is a hook to hang your purse and coat. There is a sink where you can wash your hands. There is a little basket with dental products with brand names written in some clever variation of a serif font. There is a white chair for you to recline in and Bose head phones for you to wear while you watch Netflix on a ceiling directly overhead. There are no dental tools to be seen. Do not expect to see syringes and picks and drills sitting on a tray by the chair like torturous little hors d’oeuvres.
Everything at Tend is meant to reduce the most unpleasant elements—and actual pain—of going to the dentist’s office. “Most [instruments] are air driven, they’re very loud—that whinny, horrible noise that everybody hates,” says Marc Schlenoff, Tend’s VP of clinical development and former program director at Columbia University’s Advanced Education in General Dentistry. “These are electric, they don’t make that noise, there’s almost no vibration.”
To get dental impressions, Tend doesn’t make patients bite down on a nasty tray of putty—its dentists take a digital scan. You know that gross pumice dentists use to polish your teeth? Tend has it in flavors like vanilla cupcake. The company is considering adding diffused oils or candles to the room as aroma therapy.
It’s also high-tech: Tend has online booking and a patient portal for accessing records. Onboarding, that clipboard of papers you typically fill out while you wait for the start of your appointment, is also online and can be done ahead of your visit.
How good is the dental business? In 2017, average billings for a private dental practice was $718,790 with specialty offices bringing in more than $1 million, according to the American Dental Association. To push profits higher, dentists are also adding Botox and fillers to their menu of services.
The issue of up-selling unnecessary dental services is pervasive in the industry. That’s something Tend has tried to move away from by changing its pay structure. All dentists, who are hired with at least three to four years of experience, are salaried and get bonuses based on client satisfaction, with the goal being to reduce pressure to sell, sell, sell. Dentists at Tend also have the opportunity to manage the practice or even become a partner with equity in the business.
The startup is launching in a changing industry marked by lots of smaller independent practices being swallowed up by bigger groups. Our desire to do everything on our phone has affected the tooth business. Even the Tooth Fairy is taking a hit.
“There’s an emerging trend of private equity companies acquiring up little practices and they’re called dental service organizations—it’s basically roll ups,” says Justin Joffe, CEO and cofounder of dental startup Henry. This environment has lead some to believe that the individual practice is not long for this world. After all, dentists are not business experts. Making the necessary marketing and technology upgrades to lure millennials may not be within their grasp.
At the same time the market is shifting, a collection of glossy toothbrushes, pastes, and floss have brought consumer awareness to dental hygiene. The first wave was consumer packaged goods: electric tooth brushes, tooth paste, and Cocofloss. The second wave is dental service.
One of the earliest startups in this space is Smile Direct Club, the direct-to-consumer aligner company, which did not have the rosiest of public offerings when it went public last month (its stock dropped 14% to date after debut). But it still is one of the better offerings this year. The company describes itself as nearly profitable and analysts are bullish. As Smile Direct’s future gets brighter, more investors are considering the value of a whiter smile.
But other dental service businesses are popping up everywhere. There’s Level, which operates purely as an employer-sponsored dental benefit, but like Tend operates from a storefront office in New York. Some of these companies have chosen to work with employers directly rather than through an insurer network, cutting out the middle man. There are mobile dentistry startups like Lydian, which has both fixed offices in Texas and Arizona as well as traveling 50-foot mobile offices that come to you. Joffe’s company Henry, another high-tech dentist’s office on wheels, contracts with employers to bring cleanings and root canals directly to the office. All of them are trying to improve the experience.
“We’ve designed a 38-foot dental practice,” says Joffe. “It’s got three operatories, state of the art technology, and equipment [like] Bose headphones for the patients when they’re sitting in a massage feature dental chair to watch their favorite Netflix and HBO show.”
Tend is differentiating by trying to be something of a dental tastemaker and introducing customers to a curated selection of dental brands, like Quip toothbrushes. Behind the front desk and to the right is a gleaming white wall of shelves where these products are featured prominently—like a little slice of the fast-growing industry trying to get inside your mouth.