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On a daily basis, everything is so different. As dentists, we're obviously dealing in the mouth. Depending on the scope of your practice, daily work could be as simple as cleaning teeth, examining teeth, or doing simple fillings to doing very complex reconstructions, which require multiple appointments over many months to finish. There's the whole spectrum. You can have everything from a real simple practice to something that's very complex; most dentists have something that's in between.

I employ five full time and two part time employees. There's one other dentist, who's a periodontal surgeon, as well as hygienists and my support staff. A dentist office in the simplest form is one dentist, a number of hygienists depending on how busy the practice is, and support staff.

That's correct.

The traditional model has been that you graduate from dental school and open a practice that you own as a sole practitioner. In today's world, I wouldn't say the sole practitioner is the norm. You can also work for another dentist as an associate. Or, you can work for a larger corporate entity that has multiple dentists. It depends on what you're after. There are lots of clinics out there. Choosing one depends on how you want to practice, how much money you want to make, and your personal risk level.

As a sole proprietor, I have to wear all the hats. That means I'm the human resource department, the insurance department and the dentist. I see patients for 28 to 30 hours a week, and I put in about five hours a week as an administrator.

Not all of them are active, but in total I have a couple thousand patients.

I can see as little as one patient a day to as many as 10. In addition, there are usually two hygienists who see eight patients each per day.

I'm one of those dentists who likes the client interaction a lot, but that's not always the case. A lot of dentists don't like that. Fortunately, I like the blend of both the technical aspects and the client interaction. You're dealing with a lot of people who are scared to death of being there and what you're doing isn't always comfortable. The tastes, the smells, the injections, the water dental work is not a comfortable thing. There are some patients who have complex things done and it's a breeze for them. Then there are other patients for whom even the simplest thing is a big ordeal. Everyone has different tolerance levels.

Collegial. It's a small world, different from a big corporate structure where you have to answer to a bunch of different people. It's intimate from a physical standpoint. There are not that many paces between where I do one thing and the next thing. Decisions can be made on the spot. It can be overwhelming at times when everybody wants a piece of me. I'm the guy who has to make it all happen, so at times there can be administrative issues that need my attention, I'll be taking care of a patient and have two hygienists who need exams it can get overwhelming. And there are other times when it's like, "Gosh, I'm getting paid to do this?" It fluctuates.

When I was in elementary school, there was a conversation between a physician and my parents about becoming a physician, and then he made a recommendation that stuck with me. He made a comment about how it would be better to be a dentist, given the work conditions, non-emergency situations things of that nature. That really stuck with me from an early age.

To get there I had to get an undergraduate degree and take the DAT (Dental Administration Test). The combination of your grades, scores, and other things like letters of recommendation determines if you get into dental school. Dental school is four years. During those four years you have to take two written national exams; one during your second year and one your fourth year. You have to pass both of those. You have to pass all the requirements of your dental school. Once you do that, you're eligible to take the appropriate licensing exam for your state. Not every state has its own exam; some states are part of regions that have only one test for a group of eight or 10 states.

I went to University of Michigan and got a Bachelor of Science in biology. Then I took a year and a half off and did research first at University of Michigan's medical school, then with UCLA's medical school. Then I went to Michigan for dental school and graduated in 1985.

After you take the boards, you don't hear back for a couple of months, so you're in limbo. Once I knew I had passed, I had a couple of connections. One of my instructors who also worked in a private practice recommended me, and I went to work as an associate for a little over a year. Then I passed the California boards and came out here. I looked around and bought a practice in Sacramento, and I've been with that practice for 20 years.

I bought a practice that was a runaway train wreck it had a lot of nightmare stuff going on in the insurance department and it's taken me 20 years to mold it to where I want it to be. If I had started from scratch it would be different for me: I would have kept things smaller and more intimate. If you look at your quality of dental life and your net pay, you have to get exponentially bigger to make a huge amount more money. When you're at that stage between keeping it simple and making it bigger, you have a lot of the headaches and you don't always get the financial compensation.

Because of my age and where I'm at in my life, I'm at a point in my career where I'm not in the growth phase. I'd like to see the growth level off, and take more personal time, as opposed to working even more. In my case, a lot of it depends on where my son is. If he can keep his grades up and get into dental school, I'll keep my practice at a certain level so that he can take over when he graduates. If it looks like that's not going to happen, I'll take a different path.

I go in Mondays through Thursdays, 9:30 a.m. to 5:30 p.m., with a lunch break from 1 to 2 p.m. It's about seven and a half hours a day, which makes about 30 hours a week.

I walk in the door and I'm flying. I get my cup of coffee, and then I have appointments all day long. I go from room to room, and hopefully get off in time for lunch to have a bite to eat, relax, meet up with a buddy or two. Then I come back and do it again in the afternoon. Sometimes it's so busy I never sit still. I never look at the clock to see what time it is; my days fly by. Being a dentist, at least for me, means making a series of decisions all day long; clinically and non-clinically. By the end of the day I'm pretty fried sometimes.

I don't really have many lulls, but I try to sneak all my paperwork and phone calls in during any time I have between patients. But I don't have regularly scheduled administrative time. I do what I can during the day and whatever's leftover gets done eventually.

My business manager and my assistant meet for half an hour before I get there, and go through the entire schedule. Everything's written out for me so I can look at the schedule, which is posted in a central location, and before I go into each room, I know what's going on. Every one of my patients has a treatment plan, so I have a game plan for each person. It's often a sequence of events over a period of time, and I follow that outline.

It can be anything from fillings to crowns it's all across the board.

My day is everywhere every day is completely different because in my practice we do a little bit of everything.

With new patients, because I've never met them, I can spend up to an hour meeting with them. I come in, chat with them a bit, get a sense of who they are, where they've been dentally, look at their medical records, tell them what we're up to, take x-rays, do the exam. Anything and everything we need to talk to them about, we'll try to talk to them about that day.

For a general dentist, the range is from $50,000 to $500,000 which is a wide range. On the low end, there are fledgling, marginal practices that are just making ends meet. Other people have what I call the "machines," these well-tuned, big practices and they crank it out. I just read in a magazine that the median national average for a general dentist in a city is $220,000.

Specialists are going to make more money. You can be an endodontist, who specializes in root canals; an orthodontist; or a periodontist, who specializes in gums. To do that takes four years of dentistry school and at least two years on top of that.

I work about 30 hours a week over four days. Most dentists work four days a week, eight hours per day. Some do five days, but it isn't typical.

Most state licenses require 50 hours of training and education every two years to keep you current in the field. Half of that can be done online or through at-home correspondence courses, and half must be done outside the office in attendance, like at the local dental society or at conferences. That is the bare, bare minimum it takes to stay current. I usually do about 150 to 200 hours because there's so much going on. My courses are typically in implants or cosmetic dentistry, but every dentist is different.

I'm always on-call, but I rarely ever get an emergency phone call. My patients are great. They respect us; they usually wait until Monday.

With the number of hours dentists work, it could potentially be the best ever, but it can also be very stressful. Dentists are usually pretty stressed out. Most dentists tend to get in over their head financially with their overhead expenses, and feel like they're always working to pay everything off. But if you live within your means and work your hours, you can make a really good income and have a balance between real life and work life.

Even after 20 years, I get a little concerned sometimes if I have a slow week or a slow month. But once you're pretty established you can keep a good income and a good patient base going, unless you have truly adverse publicity or there's a real big dip in the economy.

Depending on the year, I take off between four and seven weeks. We always take the Christmas holiday off. I take the Fourth of July week off. Then we take other weeks and long weekends as they come up.

In dentistry, you get the freedom of being your own businessman, but you have to provide all your own benefits. I have a medical and retirement plan for my employees.

The value of your practice when you sell it is not enough to retire on, so you have to set up something else and be diligent about saving, like through 401(k)s, SEP-IRAs, or profit sharing.

I have a different take on retirement. A lot of people don't like their jobs, and are counting the days until they retire. I like being a dentist. I don't want to do it at the pace I currently do it at, but I can work two or three days a week, make some decent money and not feel like I've had to save quite as much.

That's where dentistry is different than a lot of other occupations. You can keep your fingers in it, have a decent income and stay professionally stimulated. I could do that indefinitely, as long as my health and eyes are good and I stay interested. A lot of dentists burn out because they're working like dogs all the time. But if you can segue out of it, there's no reason you can't work a day or two a week.

When you take care of someone and they really appreciate what you do for them. You can change people's lives by fixing a front tooth or getting them out of pain. It's very satisfying. And they pay you for it!

There are things that, no matter your level of expertise, don't go the way you plan. Things break at inopportune times and it's very frustrating. Something doesn't turn out quite the way you planned, despite your best efforts. Patients may complain about your best effort, regardless of the expertise and care you're providing.

Overhead keeps getting bigger. Dentists 25 to 40 years ago made a lot more money, percentagewise. You have to generate a lot more practice production to get an income now, because overhead is increasing the cost of running a practice, staff wages, your rent, your lab costs (making crowns, bridges, dentures, partial dentures); all these factors play into your practice.

Tons. The computer generation is catching up. Computers for patient education and management have been enhanced over the years and are great to have. There are tools like a cable dent, which is a mini laser that helps you detect decay on surfaces of teeth. There are digital x-rays that decrease the amount of radiation five or six fold and are easier to manipulate. When you process things chemically, if your chemicals aren't right, you get what you get. Whereas, if you take a digital x-ray that's not quite right, you can enhance it a little bit. You can archive it better. You can blow it up. You can e-mail it to the specialist. There are advantages to going digital.

When you go to the national dental meetings, they are really pushing a lot of technology. But in the end, you can still do excellent dentistry and provide really great services for a patient with the same high-speed hand piece that's been available for 40 years.

Some of the best dentistry I've ever seen was done years ago. It comes down to the technical expertise of the dentist and the care that they do the dental work with. The trend for making crowns is to use porcelain. There's some beautiful porcelain work being done, but it's not lasting. I've seen gold crowns that are 30 or 40 years old on patients that still look brand new.

You can still do phenomenal dentistry using what we had available 20 years ago. From a practical standpoint, I'm not sure all these new bells and whistles help you do better dentistry faster. Outfitting an office with all the high-tech equipment that's out there may be impressive to patients, but it's high-dollar stuff. What's your return investment on that?

If people have extra money, they'll go to the dentist and do a lot of the elective things such as bleaching teeth, replacing teeth with implants or doing cosmetic makeovers. If things are tight, then it's usually, "What's my insurance going to cover?" You'll see discretionary spending vary with the economy.

Pain. Each community is different. If you work in an area that's more blue-collar and people don't have as much insurance, it's going to be very different than affluent urban communities. People say, "Everyone has to go to the dentist," but the regularity in which they do depends on their job situation and what they have going on.

I would, absolutely, no question about it. You know you'll have money come in the day you walk in the door. By buying an existing practice you're buying a cash flow. If you start from scratch you're going to put the same or more amount of money into renovating a space that's not a dental space. You've got a lot of money out the door at the beginning. You've got staff costs at the beginning. And you have zero patients coming in. Building from scratch is a very difficult thing.

Right now it's a buyer's market. Selling an existing practice is getting tougher because all the new dentists think it's more attractive to start a new practice from scratch than to buy an existing business. You can find them through professional sales brokers, through the local dentistry society, or with local networking.

In dentistry, practices sell for 50 - 80% of their annual gross income. What determines whether it's 50 or 80 percent? Supply and demand, and the attractiveness of your practice. Does it have old equipment that needs to be replaced? Is it state-of-the-art? What type of practice is it? Where is it located? Those are the variables.

You've got to be academically excellent. Dental school can be overwhelming; you've got to be able to keep up with all the information they throw at you. But you've also got to be good with your hands. There are a lot of super-intelligent people that don't develop the manual dexterity to be successful dentists. So, the people at the top of the class are not always the best dentists.

Then there's the business of dentistry. There are people who can be technically phenomenal but don't have the people skills to have a successful practice. Then there are the people who know their patients personally while doing marginal dental work, but the patients don't know it. They just know they're being treated in a collegial manner. So there's that personal variation that will determine success. It's not all about the technical expertise.

Yes. You can get training and get pretty decent skills, but then there are those people who are flat-out gifted and become the best. I can teach anyone to do a filling, but some people are really gifted with it and others do just okay work.

For me it's hard work, and I treat patients well. I'm a hard-working dentist and I work harder than most of my friends.

Find out where you want to live, and try to practice nearby. The type of dentistry you want to do might dictate where you live. If you want more sophisticated clientele, move to a big city or urban area. If you want to do more basic stuff, move to a rural area.

I'm just learning it now. By talking to a lot of people over the years, I've learned that it takes hard work to get to a certain point in your life, but at some point you have to back off and not make work your entire life. Not many people can get in a position to do that though. There are people who are truly passionate about their work, and there's nothing wrong with that. But there are too many people whose work consumes them and they don't have enough left over for the rest of life afterwards.

I would give anyone who came to me and wanted to be a dentist a thumbs-up and say, "Absolutely."