__Contactless check-in__

When you book a visit, we’ll collect your insurance and credit card info digitally before you come in. This helps ensure a contactless check-in experience at the studio, with nothing changing hands. And it saves you time, for a shorter, safer visit. We’ll also tell you exactly what you’ll owe, so there aren’t any surprises.

__Pre-visit health check__

Before you come in, we’ll get in touch to ask if you’ve had any symptoms of illness, or if you’ve been around anyone sick. If you have, we’ll ask you to reschedule—and make doing so super easy. Taking this step is the best way to keep everyone healthy.

__Follow-up health check on arrival__

When you arrive, you’ll find yourself in a clean, modern studio. You’ll be greeted by a team member in gloves and a mask who’ll take your temperature with a contactless thermometer. If your temperature is within normal range, great. If you show signs of a fever, we’ll ask you to reschedule. We’ll also ask you again if you’ve had any symptoms of illness, or if you’ve been around anyone sick, in case anything has changed. 

__Required hand sanitizing, masks, and social distancing__

After your health check, we’ll show you to a hand sanitizer dispenser and ask you to sanitize your hands. We require masks in the studio. If you forgot to bring your own, we’ll provide you with one. We also require everyone to maintain social distancing.

![02 Staggered Visits](//images.ctfassets.net/otz9p93fkvjx/1HYU7euJY5xIyY6VnWVOiw/5ab008420e4048053ae393ae8b672cf3/02_Staggered_Visits.jpg)

__Staggered visits and no waiting__

The studio will feel calm and quiet. This is because we stagger when our members come in for minimal overlap, [as recommended by the CDC](https://www.cdc.gov/coronavirus/2019-ncov/hcp/dental-settings.html). You’ll be seen right away, with zero waiting, so you don’t need to sit in any common areas.

![03 Welcome Gift](//images.ctfassets.net/otz9p93fkvjx/4Oqob4MvTgMDnLWNGevKpO/43757a438b8b39ddd39a78edcc50ceaa/03_Welcome_Gift.jpg)

__A welcome gift__

Before you’re seen, we’ll give you a welcome gift: a prepacked Brush Bag with oral wellness products curated by our dentists.

![04 Suite For You](//images.ctfassets.net/otz9p93fkvjx/M2D0zjxeQNi5AXWXIMz63/b90c2e0b8f6894ce92b04712980ac13b/04_Suite_For_You.jpg)

__A suite prepared just for you__

After you’re checked in, we’ll show you to your suite, which we prepare just for you. All surfaces are sanitized with medical-grade disinfectant before you come in, and all equipment is single-use or medically sterilized, a process that kills 100% of germs, including viruses. Your suite has personal space where you can hang your coat, leave your bag, and charge your phone. If you chose a Netflix show to watch when you booked, it will be queued up on a ceiling-mounted TV over your chair. If you didn’t choose one, you can do so when you sit down.

__Enhanced PPE__

Wearing gloves and a mask is standard practice for dentists, hygienists, and dental assistants. Our clinical team members wear this personal protective equipment at all times. And for enhanced safety, they also wear face shields.

__Anti-viral rinse__

Before your cleaning begins, as an additional precaution, we’ll ask you to swish with hydrogen peroxide. It’s perfectly safe, and rinsing with it greatly reduces the viral load in the mouth, if one exists.


__Fast, comfortable, and safe imaging__

Our state-of-the-art Planmeca Promax 3D imaging machine moves around your jaw instead of poking the roof of your mouth or making you gag. This machine turns x-rays into a comfortable, 30-second process. Because the machine is less invasive, it’s less at risk of spreading germs. It also uses 80% less radiation.

![05 Thorough Cleaning](//images.ctfassets.net/otz9p93fkvjx/6b1R4REld286tFfNgRvCHu/d9cc9bdeb17bdeb43e09f5f424ce9f29/05_Thorough_Cleaning.jpg)

__A thorough, gentle cleaning__

After you’ve wrapped up your imaging, you’ll return to your suite. Your hygienist will give you a thorough, yet gentle cleaning, using a topical numbing gel so you won’t feel a thing. For added safety, we use manual tools to avoid aerosolizing germs.

__A beautifying polish__

When your cleaning is finished, your hygienist will give you a polish to remove any cosmetic staining on your teeth. You’ll get to choose between mint polishing paste or a fun flavor like vanilla while you keep watching Netflix.

![06 Expert Exam](//images.ctfassets.net/otz9p93fkvjx/1GQh1bzmLStbK6y5U3FrsS/ad91d04d3936acaa44252c2fd391f8cf/06_Expert_Exam.jpg)

__An expert oral exam__

When your polish is finished, your dentist will come in and answer every question you have. Then they’ll examine your mouth and talk to you about your oral health with zero judgment. As part of your exam, you’ll get a complementary oral cancer screening. Since the mouth can be a front-line indicator of many diseases, dentists can identify early symptoms before they become more serious.

__Only the care you need__

If your dentist recommends additional care, they’ll show you exactly why by showing you a picture of your mouth on a screen. And you can make a decision about whether to proceed confident that your doctor’s interests and yours are truly aligned. Our doctors aren’t paid a commission on procedures, so they only offer the care you actually need.

__Same-day dentistry__

Instead of asking you to come back at another time for treatment, we offer same-day dentistry. This reduces the number of trips you need to make, limiting exposure to germs while in transit. If you’d prefer to come back at another time instead, that’s completely fine.


__Contactless check-out__

That’s it. Your checkup is finished. If you owe anything for your visit, we’ll charge the card we have on file, so nothing needs to change hands. We’ll see you in six months!


Care at Tend isn't just painless, it's a pleasure.

Safe, soothing dentistry

When you book a visit with Tend, here’s what to expect.

01 Contactless CheckIn

Your First Tend Visit

The Gargler

Dear Plaque

Tend Logo

2 jKiLae-nkh9Ixj3kt9aVzQ

MorningVsNight Horizontal

Do I Really Need to Brush Twice Per Day?

01 Hero DrSchlenoff2

Weed: How Bad Is It?

Seltzer Horizontal

0 ootGL4k38DTycw4T

Grinding_Horizontal

Charcoal: Is It Legit?

OutOfNetwork Horizontal

Tend

Why Being Out of Network Can Be a Good Thing

Doug Hudson

On March 20th, with Covid-19 cases in New York City skyrocketing, we closed our studios to do our part in managing the pandemic. Today, with cases on the decline, we’ll begin the process of reopening. But the “Tend” our patients experience now won’t be the same as before. We’ve remade every moment of our patient journey to put the health of our patients and our team first.

When we first opened in 2019, we rethought every little detail of going to the dentist to create a soothing, trustworthy, judgment-free, and personalized experience that our patients would actually look forward to. We used the same approach to reimagine dentistry for a post-Covid world. Our safety measures aren’t simply bolted onto the experience we built before. They’re a fully integrated part of a brand-new experience that we redesigned from scratch.

These are the three areas we focused on:

![02 Safety Through Digitial3](//images.ctfassets.net/otz9p93fkvjx/1DaeWeKwcGwWuz6nmatuCW/ea3b997c82bbf56e79008a494dec46b8/02_Safety_Through_Digitial3.jpg)

__Safety through digital innovation__

Pre-Covid, we checked insurance cards and took credit cards at the front desks in our studios. Today, we collect this information digitally before you come in. This ensures a contactless check-in and check-out experience at the studio. It also saves you time for a shorter, safer visit. The custom intake flow we created is fast and seamless with very few clicks, no forms to print out and bring with you, and no annoying phone calls back and forth.

Three days before your visit, we reach out by email to perform a health check. We ask if you’ve experienced any Covid-19 symptoms, or if you’ve been exposed to anyone sick. If you have, we make it super easy to reschedule.

![03 Reimagined In Studio](//images.ctfassets.net/otz9p93fkvjx/1KwueR5Jm74XNPyWYBFnYm/ac9233a652c59ce335a88564065d3269/03_Reimagined_In_Studio.jpg)

__A reimagined in-studio experience__

Pre-Covid, we promised zero waiting at our studios. Today, we make the same promise, but we stagger visits with even more buffer time to minimize patient overlap. This means you’ll arrive in a calm, quiet space where you’ll be seen right away, without sitting in any common areas or passing other patients in the halls. And, of course, we require masks, social distancing, and hand sanitizing for all inside.

We also perform a temperature check on arrival and a follow-up health check, to make sure you haven’t developed any new symptoms or been exposed to anyone sick. Before your checkup or procedure begins, we ask you to swish with an antiviral rinse that reduces the viral load in the mouth, if one exists. This measure helps keep our team safe. And by protecting our team, it ultimately protects you.

Medically sanitized surfaces and sterilized equipment are standard practice for dental offices. For clinical team members, so is wearing PPE like masks and gloves. We are stepping up these practices by cleaning every surface you might touch, just for you, before you come in, professionally sanitizing our studios every night, and enhancing our clinical team’s PPE by adding face shields.

![04 Only The Visits](//images.ctfassets.net/otz9p93fkvjx/1CsXMw6oxfSwXFFTp1sUj4/ee243c2cb05e2b94026cdfdd6e5dc72a/04_Only_The_Visits.jpg)

__Only the visits you need__

Pre-Covid, if one of our dentists recommended that you get additional treatment like a filling, we’d ask you to come back on another day. Today, we offer treatment right away to reduce your trips to and from the studio and your germ exposure while in transit.

Ever since we closed our studios on March 20th, we’ve been offering free virtual visits. We are continuing to offer virtual visits. If you’re not sure whether you need to be seen, give us a call. We’ll talk through your concern and give you a recommendation on how to proceed, weighing how you feel with what you’re comfortable with, given your health and family circumstances.

![05 Whole You Focus2](//images.ctfassets.net/otz9p93fkvjx/2XpMGsDxwfFPTDtLlIW6IO/7d058a9eec54cd916b2f2d0df83c7263/05_Whole_You_Focus2.jpg)

__A whole-you focus__

From the virtual visits we’ve conducted, we know that New Yorkers have been living with significant dental issues for weeks or months. They need restorative and, in some cases, emergency care that they haven’t been getting. We are reopening for them. And as soon as you’re ready, we’ll be here for you.

When we reimagined dentistry the first time, we focused on reframing your expectations about how relaxing it could be. How credible. How accepting. How customized. Today, we want to reframe your expectations again. We want you to look forward to your visit because you know that we’re putting your safety first with new digital tools, a new in-studio experience, and only the visits you actually need.

Oral health is important. But it’s just one part of overall health. We are focused on the whole you.

— Doug and Marc 

*Doug Hudson is the CEO and Co-Founder of Tend. A serial healthcare entrepreneur, Doug has founded and led several consumer-facing ventures, including serving as founding CEO of SmileDirectClub and Chairman and CEO of DiabetesCareClub, CPAPCareClub, and HearingPlanet. He splits his time between NYC and Nashville with his wife and three daughters.*

*Dr. Marc Schlenoff is Head of Clinical Development at Tend. Prior to Tend, Dr. Schlenoff was a Program Director at Columbia University’s College of Dental Medicine. He was also the Medical Director for Columbia University Health Care. The Consumer’s Research Council of America named Dr. Schlenoff one of America’s Top Dentists for nine consecutive years.*


Reimagining Dentistry for a Post-Covid World

We all know that smoking cigarettes is awful for oral (and overall) health—[thank you, decades of PSAs from the CDC](https://smokefree.gov/quit-smoking/why-you-should-quit). But what if what you’re smoking doesn’t contain tobacco? As the availability (and legality) of marijuana increases nationwide, it’s natural to wonder if increased use is as harmful to your mouth as tobacco products are. 

To find out, we sat down with resident expert Dr. Marc Schlenoff, Tend’s Head of Clinical Development.

__Smoking pot has been linked to gum issues__

“There have been studies that show that marijuana can be a causative factor in periodontal disease,” says Dr. Schlenoff. Meaning, we’re less worried about the effect smoking marijuana has on your teeth, and more worried about the effect it can have on your gums. [According to a 2017 study from Columbia University published in The Journal of Periodontology](https://www.dental.columbia.edu/news/recreational-cannabis-used-often-increases-gum-disease-risk), “frequent recreational use of cannabis—including marijuana, hashish, and hash oil—increases the risk of gum disease.” 

“You can tell a smoker by the way their gums look,” explains Dr. Schlenoff, “They’re sort of a grayish color because there’s not a lot of blood in there.” Researchers have long understood that the combination of nicotine—which constricts blood vessels—and heat in cigarettes [can restrict blood flow to the gums](https://www.cdc.gov/tobacco/campaign/tips/diseases/periodontal-gum-disease.html), which leaves them vulnerable to infection. And it seems the Columbia study has found the same link with marijuana, a nicotine-free substance. 

__Vaping may be just as bad (or worse)__

When it comes to the newest trends on the market, the research is less clear cut, since there hasn’t been enough time to conduct studies focusing on long-term effects. “We just don’t have that kind of data yet,” explains Dr. Schlenoff. 

That said, [you may have seen headlines](https://www.foxnews.com/health/vaping-harming-teeth-study) warning about the effects of vaping on your teeth and gums. It’s not hard to imagine why: exposing your gums to heat restricts blood flow. Plus, most [e-cigarette liquid typically does contain nicotine](https://smokefree.gov/quit-smoking/ecigs-menthol-dip/ecigs), which is a known oral health offender. The bottom line: when it comes to vaping, signs point to it being risky for your oral health—and, of course, your overall health, as vaping has been increasingly linked to [severe and even fatal respiratory problems](https://www.fda.gov/news-events/public-health-focus/lung-illnesses-associated-use-vaping-products). 

__CBD results have been more positive__

CBD, on the other hand, may be a different story. There is some preliminary research that suggests cannabidiol (the chemical name of CBD) [may prevent bone loss](https://www.ada.org/en/member-center/oral-health-topics/cannabis), which would help keep your teeth stable and sturdy. However, it’s very preliminary: so far, it hasn’t even [been tested](https://www.ncbi.nlm.nih.gov/pubmed/25517414) [on humans](https://www.ncbi.nlm.nih.gov/pubmed/19070683). And importantly, all studies involved CBD that was injected or consumed, not smoked.

__All things in moderation__

So is the occasional pot smoker or vaper doomed, then? When it comes to incidence of gum disease for smoking, at least, Dr. Schlenoff says that “it’s very clear that your risk is proportional to how much you smoke.” 

The more you smoke, the higher the risk. The same is likely true of vaping. (For weed and CBD gummies, there’s currently too little research to know.)

Be frank with your dentist. Not comfortable talking to your dentist about this kind of thing? Maybe it’s time for a new dentist. This shouldn’t be an awkward conversation.

Worried about your own habits?

In our “How Bad Is It?” series, we answer your cringing questions about whether something you’ve done, or do everyday, is bad for your oral health (or completely harmless).


“If you do it right,” says Dr. Marc Schlenoff, Tend’s Head of Clinical Development, “there’s no reason to brush more than once per day.”

“Doing it right” means brushing so thoroughly that if you were to use a disclosing tablet that reveals plaque on your teeth, you wouldn’t find any. Plaque builds up every 24 hours, so in theory one perfect brush per day should do it. (If plaque is left unbrushed for more than 24 hours, it will layer, harden, and damage your enamel.) 

But here’s the catch: “doing it right” is really, really hard (even for a dentist). It requires a level of thoroughness most of us aren't used to. 

That’s why—even though you could brush once per day—“you shouldn’t,” according to Dr. Schlenoff. Brushing a second time helps remove “any plaque you missed” during round one. And unless you’re a superhuman brusher, you need that. 

So stick with it!

If you want a judgment-free, educational dental experience, you've found the right place. Book a visit with one of our amazing dentists and hygienists at your nearest studio.

We answer the questions you're afraid to ask

You’ve probably been hearing all your life that you need to brush twice per day. But—prepare to have your mind blown—you don’t necessarily have to.


If you keep up with the latest wellness trends, you’ve probably heard about charcoal. In the last few years, it seems to have lent its pitch-black hue to just about everything: skincare, ice cream, lattes—and oral wellness products. We’ve seen charcoal show up in toothpaste, mouthwash, floss, and even the bristles of toothbrushes. But what’s it actually doing there? 

We checked in with Dr. Marc Schlenoff, Head of Clinical Development at Tend, to get to the bottom of the charcoal trend. 

__The claim: activated charcoal helps you “detox”__ 

Activated charcoal, the flavorless ingredient at the heart of the movement, is essentially a form of carbon that’s been treated to make its surface more porous. Theoretically, the holes on the surface of charcoal particles help them pick up and clear away other substances. 

It’s why you so often hear the word “detox” in connection with charcoal. The idea is that ingesting it, washing your face with it, or even brushing your teeth with it helps draw out chemicals and impurities, leaving behind a flushed body, clearer skin, or, in your mouth, pearlier whites and fresher breath. 

__The reality: when it comes to your teeth, there’s no proof__

“I went through the research,” explains Dr. Schlenoff, “and I couldn’t find one single solitary study that advocated for charcoal among independent, unbiased analyses.” 

He’s not alone in that finding: [according to a 2017 review from the Journal of the American Dental Association](https://jada.ada.org/article/S0002-8177(17)30412-9/fulltext), there’s “insufficient clinical and laboratory data” to substantiate any safety or efficacy claims about charcoal in toothpaste. 

__Charcoal could be really bad for your chompers__

Charcoal is abrasive, and there’s concern among dentists that, over time, exposing your teeth to it could wear away your enamel. “No matter how finely you grind up the particles it’s still abrasive,” adds Dr. Schlenoff. 

[A study presented at the 2015 Academy of General Dentistry Annual Meeting](https://www.epostersonline.com/agd2015/node/72) found that activated charcoal was more abrasive than traditional whitening toothpastes (and suggested it may not be that effective as a whitener). 

__Excess abrasion can actually lead to yellower teeth__

[The American Dental Association](https://www.mouthhealthy.org/en/az-topics/w/natural-teeth-whitening) cautions that using overly abrasive materials on your teeth can actually make them look less white and more yellow. That’s because if you totally wear away your enamel, you’ll expose the layer below: dentin, a softer, less protected substance that (you guessed it) is yellow in color. 

__Been brushing with charcoal? Don’t panic__ 

A single tube of charcoal toothpaste is unlikely to cause that much damage. That’s because when it comes to abrasion, “it’s cumulative,” assures Dr. Schlenoff. The longer—and harder—you brush, rinse, or floss with charcoal, the greater the risk. 

__And if you’re using charcoal mouthwash, consider safer alternatives__ 

“It’s not worth the risk at all,” says Dr. Schlenoff. When it comes to fresh breath or whiter teeth, “there are much safer ways to achieve that result.”

Check out our online shop. It has toothpastes hand-picked by our dentists. They're safe, and you'll love using them every day.

Need a charcoal-free toothpaste?

In our “Is It Legit?” series, we weigh in on trendy topics in oral wellness, flossing fiction from fact so you know what to trust your mouth with. 


I’m just going to get to it: I’m breaking up with you. That fuzzy feeling you give me just isn’t doing it anymore.

I know this may come as a shock to you, but I’ve felt this way for a while and was just too scared to act on it. The truth is, I’ve finally found someone who will be there for me, who’s a lot nicer than I ever could’ve imagined, and most importantly, makes my teeth strong instead of weak: my new Tend dentist.

I’ll always remember our good times: eating candy at the movies, all the times I forgot to floss or brush and you stood by me, growing in the night. Because you thrive in the bacteria of an unbrushed mouth, it couldn't be helped. I’ll always cherish how hard we laughed about how gross my breath smelled that one morning. Or how your friends Tartar and Cavities kept overstaying their welcome. 

But that’s the thing though, right? Our relationship was never just us. If it was just you and the other millions of friendly bacteria in my mouth, it would be one thing. But I’m slowly accepting that you and your buds are a package deal. And I deserve better than that. 

I know you’ll come back to me. That’s only natural. But I feel compelled to warn you: my new Tend dentist will always be there to support me in getting rid of you again.

Maybe one day we can get to a point where we’re friends, where we can give each other heartfelt hello’s as I scrape you off my teeth at night. But for now, I’m going to make a clean break. I hope you understand.

Don’t cry because it’s over. Smile because of all the candy we ate.


Our amazing clinical team can help. They're really good at writing breakup letters to plaque like this one.

Ready for a breakup?

In some ways this is the hardest letter I’ve had to write. And in some ways it’s the easiest.

It’s hard to crack open your third (or fourth, or fifth…) can of the day and not feel a little worried that seltzer drinking could be damaging your teeth. What’s actually in seltzer? And does it matter for your oral health?

To find out just how bad—or not—a sparkling water bent can be, we sat down with Dr. Marc Schlenoff, Tend’s Head of Clinical Development.

__Seltzer drinking isn’t something to lose sleep over__

Compared to drinking soda and other not-so-great-for-you beverages, drinking seltzer “isn’t really something to worry about,” says Dr. Schlenoff.

__Unless your seltzer contains citric acid__

When it comes to your teeth, the danger of many canned and bottled drinks, even the sugar-free ones, is mostly centered on a single ingredient: citric acid. Citric acid is naturally found in citrus fruits, and an artificial version is commonly used as a preservative and flavor-enhancer in some of America’s favorite bevvies.

__Citric acid erodes enamel__ 

By lowering the pH of your mouth, citric acid can [erode your enamel](https://www.ada.org/en/member-center/oral-health-topics/erosive-tooth-wear). Combine that with another popular ingredient—sugar—as many soft drinks do, and, according to Dr. Schlenoff, you’ve got the “perfect conditions for tooth decay.”

__Seltzer is more acidic than water__

“Part of the seltzer-making process involves mixing water with something called carbonic acid,” explains Dr. Schlenoff. (That’s the “carbon” in “carbonation.”) “So there’s a little bit of acidity that’s brought into the mix,” which is one reason seltzer tastes good.

__But only slightly__

The acidity “isn’t dramatic,” says Dr. Schlenoff, though he cautions that seltzer companies don’t share the exact pH levels of their products with the public, so it’s [hard to know what the long-term effects of drinking them will be](https://cspinet.org/tip/your-seltzer-habit-harming-your-teeth).

__To play it safe, swish with water__

“All it takes is a swish of water to rebalance the pH of your mouth,” says Dr. Schlenoff. So after you get your seltzer fix, swish with water for a few seconds to bring your mouth’s pH level back to normal. But before you do anything else, check your favorite brand’s ingredient list. And if you see citric acid or sugar, take out a water glass instead.

That’s why we call ourselves a dental wellness company. We help you form healthy habits with personalized nutritional tips, product recommendations, and more.

We believe dentists shouldn’t just solve problems. They should prevent them.

*In our “How Bad Is It?” series, we answer your cringing questions about whether something you’ve done, or do everyday, is bad for your oral health (or completely harmless).*

Seltzer: How Bad Is It?

When you’re looking for a dentist, you’re probably aiming to check a few different boxes: you want your dentist to be close to where you live or work, you want them to have good reviews, and you want them to take your dental insurance (if you have coverage). 

On this last point, you’re probably looking specifically for someone who’s “in network” with your insurer. “Out of network” feels like something to avoid: we associate it with more expensive care, specifically big surprise bills that show up in the mail months later.

And these associations are often justified. If a dentist is “in network,” it means they’ve negotiated set rates with your insurer. So you’ll just owe your normal deductible and coinsurance. If a dentist is “out of network,” they may bill you for more than your insurance will pay. Thus the surprise bills.

However,  if Tend is out of network with your insurer (we can’t speak for the other guys), it can actually be a good thing. 

For 80% of our out-of-network guests, checkups are *fully covered*. By checkups, we mean your twice-per-year cleanings, with x-rays, an oral exam, and a polish. We also include a free oral cancer screening ($60 value), so you get more thorough care than you might elsewhere, without paying anything extra.

Summed up, if you’re coming in for a checkup, there’s only a 1 in 5 chance that being out of network will be any different than being in network. And if you’re in that 20%, we’ll make sure you know ahead of time and allow you to cancel, no questions asked.

If you have more questions about being out of network, give us a call at (212) 686-3686. We’ll talk you through it. 

See exactly what you’ll owe for your checkup with our real-time insurance checker.


See if your checkup is covered

With Tend, being out of network can actually be a good thing.

“If you had to choose, __brushing at night is more important__,” says Dr. Marc Schlenoff, Tend’s Head of Clinical Development.

At night, you’re brushing away “the accumulation of sugary and acidic things we all eat and drink throughout the day.” In the morning—unless you’re a midnight snacker (which, fair)—your teeth are still pretty clean, since they haven’t really been used. Brushing in the morning is more about freshening your breath and getting rid of any plaque you missed the night before. 

That said, __Dr. Schlenoff definitely does not recommend skipping your morning brush.__ Long-term it will affect your oral health, and short-term people may “stand a little further away from you.” But let’s say you’re a parent negotiating with a particularly brushing-averse kid: if you have to give up something at the bargaining table (just once), now you know what to do.


No matter when you brush, our dentists will make you feel completely and utterly care for.

No judgment ever

Brushing twice per day is standard practice. But are the two brushing moments equally important? The answer, it turns out, is no. 

Is Brushing at Night More Important Than in the Morning?

We’re often simply told we do it, recommended an expensive mouthguard, and sent on our way with little to no more information. But *why* do we grind our teeth in the first place? Do I *have* to wear my night guard? And is grinding *really* such a big deal? Tend’s Head of Clinical Development, Dr. Marc Schlenoff, has these answers and more. (Spoiler: yes, grinding is, in fact, a *very big deal*.)

__Grinding can be caused by stress, but it’s also genetic__

While a lot of us grind due to stress, “some people who are seemingly under no stress grind because that’s just the way they’re hardwired,” says Dr. Schlenoff. 

__Grinding produces a huge amount of force__

“Grinding can generate up to 1,100 pounds per square inch of pressure on your teeth.” To put that in perspective, that’s [3-6 times](https://www.chicagotribune.com/lifestyles/health/sns-health-teeth-stress-story.html) the pressure you use to eat.

__Evidence of grinding is easy to spot__

When people grind, the cusps of their teeth gradually become flatter, and shinier, then shorter. “I always show my patients a picture of the wear to show them exactly what’s happening,” says Dr. Schlenoff.

__Grinders typically grind for an hour or so per night__

“We grind and clench and then we stop and then we do it again...all night long,” says Dr. Schlenoff, adding up to about 60 minutes total.

__You’re more likely to grind if you snore__

Some snorers assume they couldn’t possibly grind their teeth while snoring, but sadly they’re wrong. In reality, “grinding is just momentary, and there’s almost a 100% correlation between snoring and grinding.”

__Grinding wears away at enamel, then at dentin__

Now for some dental anatomy: a tooth has layers that grinding destroys bit by bit. The first layer is the enamel, which coats the outside of the tooth and is “the hardest substance in the body.” Once you grind through this, you’re in trouble. Underneath the enamel is “dentin,” a yellowish substance that’s 11 times weaker than enamel. As a result, it will erode 11 times more quickly.

__Grinding affects multiple teeth at a time__

Grinding doesn’t just happen to one tooth: it occurs in a sliding motion that wears down many of your teeth simultaneously in a fairly symmetrical way. 

__There’s a point of no return when it comes to tooth damage__

Because the tooth gets softer the deeper you go, over time the damage grinding causes begins to accelerate. At a certain point, the damage is beyond repair and your teeth will require crowns. Dr. Schlenoff recalls, “I’ve had cases where I had to do crowns on every tooth in the mouth to rebuild them to their original height because people have worn them down so dramatically.”

__Repairing this damage can be incredibly expensive__

A single crown can cost up to $2500, depending on where you live. If your case is really extreme and you need crowns on every single tooth like Dr. Schlenoff’s patient, that could result in a whopping cost of $80,000. 

__There’s a way, way cheaper alternative__

Since there’s no way to consciously stop grinding (especially in our dreams), our best mode of defense is a night guard, or a simple piece of plastic custom-molded to your mouth that you wear just when you sleep. A night guard typically costs less than a thousand dollars. We charge $599 if you don't have dental insurance, and if you do, it could cost significantly less than that. That’s a savings of $79,401 or more if things were to really go awry.

Here’s to strong enamel, and grind-free teeth!

Book a Checkup at your nearest Tend studio, and one of our top-rated dentist will examine your teeth for signs of wear. 

Think you're grinding?

[8% of adults](http://sleepdisorders.sleepfoundation.org/chapter-7-sleep-related-movement-disorders/sleep-related-bruxism/p/) grind their teeth, but most have no idea about the long-term consequences.


80,000 Reasons to Stop Grinding Your Teeth

Maybe you’ve walked by our Flatiron Studio. Maybe you’ve seen “Look forward to the dentist” or “A new kind of dental office” in the windows of our upcoming FiDi and Midtown Studios. Or in an ad online. Maybe you’ve visited our website. Maybe you’re intrigued.
*Who are these Tend people? They’re hiring. Do I want to work for them? Do they want to hire me?*

In my last post, I talked about how Tend is innovating for our guests. We want to be the first dental experience they actually look forward to. Dear dentists, today I want to talk about how we’re innovating for you. We haven’t just rethought dental care from the patient’s perspective. We’ve rethought it from yours.

# A beautiful place to work

Our studios are designed to soothe. Gorgeous tube lighting. Warming wooden paneling. A custom fragrance in the air. They’re also designed to earn trust. Simple, encouraging hues. Framed diplomas on the walls. Screens in front of each chair so guests and dentists can discuss treatment with imaging as a common reference point. And they’re designed to reframe expectations. A room just for freshening up with swishy, swirly walls. Super-friendly front desk staff. Netflix on ceiling-mounted TVs.

For you, this means calmer, more trusting patients, who are actually enjoying their experience. It also means working in a gorgeous, elegant office, equipped with a lounge where you can eat, meet, and relax.

![1 SpQ75pu5tXdnXg4Ew9bV5Q](//images.ctfassets.net/otz9p93fkvjx/5oUKnYsgFJCPMqCZPF5i3s/6efe97e3bb82f80732e46bcb0217a3f3/1_SpQ75pu5tXdnXg4Ew9bV5Q.jpeg)

# State-of-the-art tech

Like many forward-thinking dental practices, we’ve invested in the latest technology. Extra-oral x-rays with 80% less radiation. Quieter handpieces. Scalers that don’t require a spit bowl. We see faster, more comfortable care as key to reframing our guests’ expectations about what dental can be. That means state-of-the-art tools at your fingertips.

Our investment in tech extends beyond hardware. When our guests book visits online, for example, we ask them for their insurance info and their medical history. This streamlines in-studio operations and reduces wait time, which makes our guests happier and more relaxed when you see them.

![1 2BatcABlJgvuNpa 8xY9NA](//images.ctfassets.net/otz9p93fkvjx/55EWV2dIc5GUBoMSzNrqKQ/9ef5fb0d7a46c8ed3cbadf7d130da9ed/1_2BatcABlJgvuNpa_8xY9NA.jpeg)

# A culture of collaboration

If you’re a Tend dentist with a complex case and you want input from a colleague, you have an array of resources available to you. You can consult with another dentist in the studio where you’re based. You can call on the broader network of Tend dentists. Or you can turn to Dr. Marc Schlenoff, our Head of Clinical Development. Until he joined Tend this year, Dr. Schlenoff was Director of Advanced Education in General Dentistry and Assistant Professor of Prosthodontics at Columbia University’s College of Dental Medicine. Before Columbia, Dr. Schlenoff was in private practice for more than 30 years with a specialization in aesthetic dentistry. He collaborates with our clinical team as a whole to make sure each of our dentists feels 100% supported.

![1 52UwH2sfzwwH2A5sHqrAVQ](//images.ctfassets.net/otz9p93fkvjx/6zbd5B1jg4NHpV9eQruK0u/c3632853e1761595788dbac56b7e7e43/1_52UwH2sfzwwH2A5sHqrAVQ.jpeg)

# Continuing education

Dr. Schlenoff’s role includes continuing education. He’s created a program, called Tend University, that keeps our clinical team up to date on all of the latest developments in science-based care. It also delves into the business side of dental. You may be the world’s most incredible clinician, but you may still be able to learn something about hospitality: how to talk to guests in different consumer segments at different points in their journeys, for example. Or you may still be able to learn something about leadership: how to run a huddle, how to hold people accountable, how to do talent reviews. Combine skills like these with your existing clinical abilities, and you’ll be a powerful operator.

# A new win-win approach to compensation

If you’re a dentist who earns a commission on procedures, your pay month-to-month may be unpredictable. You may also detect a sense of distrust in your patients that, for the vast majority of clinicians, is totally unfair. Are your treatment recommendations really in their best interests, your patients may wonder, or are they in yours?

This perceived conflict of interest can make things awkward fast. Let’s say you’re seeing a brand-new patient who needs work done, but they’re asymptomatic. Now you have to do an internal calculation: should I bring my diagnosis up now and risk making my patient feel suspicious? Or should I wait to gain their trust, potentially delaying care to their detriment?

We’re eliminating this problem with a new win-win approach to compensation. We pay you a competitive base salary with an additional bonus based on several key metrics, including Net Promoter Score (a common experience metric that measures guest satisfaction). This provides stability for you, aligns your interests with your guests’, puts your guests at ease, and ultimately makes them more likely to accept the care they need. It also takes productivity out of the equation.

![0 4EEThGxoSoIbVDVF](//images.ctfassets.net/otz9p93fkvjx/1KdZ2mizyT636kIxuiw5Kd/42ad8183c8a1a6d656d927a543274436/0_4EEThGxoSoIbVDVF.gif)

# Three common career paths

Many dentists choose between three common career paths: 1) starting their own practice, 2) working for another practice or practices, or 3) joining a dental support organization.

Starting your own practice allows you to build something from scratch, which is an extremely rewarding experience. But it will put you (on average) $475,000 in debt. And that’s on top of the debt you likely already have. In 2018, the average dental school graduate owed $285,184 (a 400% increase since 1990), according to the ADA. Starting a practice also requires skills you might not have acquired in dental school: how to market, hire, manage an office, look great on social media and third-party booking sites, and so on. If you’re like most dentists, you got into the field because you love taking care of people. You don’t necessarily love marketing performance metrics or training front desk staff.

Working for another practice is an option. You can pay down some of your debt and hone your clinical chops. But unfortunately you’re at the whim of the practice or practices you contract with, and that may mean irregular hours, or shifts at different practices on different days of the week. This route keeps your options open, but without a partnership track, it won’t help you build a long-term, sustainable practice of your own. It also doesn’t necessarily provide mentorship.

Joining a dental support organization can provide stability. You know you’re part of a larger parent company that can do the heavy lifting when it comes to marketing and operations. But most DSOs are fully staffed in the major markets you most likely want to live in. They also tend to operate their practices as silos, so there isn’t a strong culture of collaboration.

![1 Vg2hh7NXlBPhCNIOz3o3aA](//images.ctfassets.net/otz9p93fkvjx/wO2JQFnsK6zbHlQTX3TvM/9c14979cb7a0d3fb2b6e928a40775419/1_Vg2hh7NXlBPhCNIOz3o3aA.jpeg)

# A fourth option: Tend

I want to personally offer you a fourth option. Tend is currently opening studios in Manhattan and Brooklyn, and we need outstanding dentists to build them into thriving practices. Most of all, we’re looking for dentists who want to change the way dentistry is perceived. To shift the conversation from fear to anticipation. Lack of trust to confidence. Pain to comfort. So-so to out of this world. We want our guests to look forward to seeing you.

Sound like something you want to be a part of? Drop us a line.

*A letter from our CEO, Doug Hudson, to dentists everywhere.*