Howard Farran DDS, MBA

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Howard Farran DDS, MBA Founder & CEO of dentaltown.com His area of expertise covers many aspects of dentistry, including the business of dentistry and clinical topics.
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Howard Farran, DDS, MBA, is a practicing dentist with more than 25 years of clinical experience, as well as a noted international speaker on faster, easier, more efficient dentistry. He has captivated audiences around the world with his innovative, informational, off-the-cuff and entertaining lectures for more than two decades.

GERD and Dental Erosion: Before You Rebuild, Find the CauseWhen severe tooth wear walks through the door, the first ques...
10/18/2026

GERD and Dental Erosion: Before You Rebuild, Find the Cause

When severe tooth wear walks through the door, the first question shouldn’t be composite or ceramic, crowns or additive dentistry.

It should be: What destroyed these teeth, and is it still happening?

A 2022 meta-analysis found dental erosion in about 52% of patients with GERD versus 21% of controls. But erosion does not diagnose GERD. Reflux, vomiting, dietary acids, xerostomia and mechanical wear can overlap. GERD and bruxism can coexist.

The clinical sequence matters:

Recognize the wear. Investigate the cause. Control the disease. Determine whether it is still active. Preserve what remains. Then restore.

Direct composite offers conservation and repairability. Adhesive ceramics may offer greater durability. Increasing vertical dimension can sometimes create restorative space instead of drilling it away. Ferrule matters, but ferrule does not automatically mean crown lengthening.

The goal isn’t Team Composite or Team Ceramic. It’s keeping the patient’s natural teeth for as long as possible.

A spectacular before-and-after photo gets attention. The photo five or ten years later tells us whether we really understood the disease.

Can a Tooth Infection Actually Kill Someone? Yes, but fortunately it is rare. Dental decay itself almost never kills. Th...
10/18/2026

Can a Tooth Infection Actually Kill Someone? Yes, but fortunately it is rare. Dental decay itself almost never kills. The danger begins when infection reaches the pulp, escapes the tooth, and spreads into deep tissues, the bloodstream, the chest, or the brain.

A 2026 JADA study found nearly 9,000 U.S. hospitalizations per year in which periapical abscess was the primary diagnosis. Among those patients, about eight died per year. An earlier national study found a similar number, about seven deaths annually.

That does not mean only seven or eight Americans die each year from dental infections. Once infection spreads, the final diagnosis may be sepsis, brain abscess, mediastinitis, pneumonia, or airway obstruction, so the original dental source can disappear from the mortality coding. The true number is unknown.

The real clinical issue is recognizing when a routine dental infection is no longer routine. Warning signs such as facial or submandibular swelling, fever, dysphagia, drooling, trismus, tongue elevation, muffled speech, difficulty handling secretions, respiratory distress, or inability to lie comfortably supine may signal deep space infection or impending airway compromise.

The real world cases are sobering. Former NFL player Mike Williams died at 36 from bacterial sepsis with cerebral abscesses and necrotizing pneumonia due to multiple dental caries and retained roots. Twelve year old Deamonte Driver died after an abscessed tooth spread infection to his brain.

The lesson for dentists is simple. Treat the source, not just the symptoms. Antibiotics may suppress infection, but they do not eliminate the source. Explain that less pain does not always mean the infection is gone. Escalate quickly when deep space spread or airway compromise is suspected.

Dental caries is the most common health condition in the world. Fatal odontogenic infection is rare. Both statements are true. Are we communicating the urgency of definitive treatment clearly enough?

Is Dentistry Becoming Medicine? American medicine offers dentistry a warning. Physician private practice fell from 60.1%...
10/17/2026

Is Dentistry Becoming Medicine? American medicine offers dentistry a warning. Physician private practice fell from 60.1% in 2012 to 42.2% in 2024. Dentistry is not there yet. About 73% of dentists were practice owners in 2023, but DSO affiliation reached 27% among dentists less than 10 years out of school.

The encouraging news is that younger dentists may be delaying ownership rather than abandoning it. Among 2006 to 2010 graduates, ownership eventually reached 81% by 15 to 19 years after dental school.

That distinction matters. Working for a DSO at 30 and owning at 40 represents a changing career path. Remaining an employee at 50 represents a changing profession.

The real battle may be economics. If rising expenses, staffing challenges, debt and administrative burdens make employment more attractive than ownership, consolidation becomes rational.

Dentistry does not need to preserve the solo practice of 1985. Dentist-owned groups can share purchasing, HR, billing, technology and AI while preserving meaningful dentist ownership and clinical control.

Medicine shows how professional independence can disappear one rational transaction at a time. If dentistry wants owners, dentistry has to make ownership worth owning. Will today’s young dentists still own dentistry 20 years from now?

Artificial intelligence is already reshaping radiology, scheduling, claims, treatment planning, marketing, call conversi...
10/17/2026

Artificial intelligence is already reshaping radiology, scheduling, claims, treatment planning, marketing, call conversion, and patient communication.

The question is no longer whether AI is real. It is whether dentists will mistake a revolutionary technology for a good investment at any price.

In the 1800s, railroads transformed civilization, but investors still overbuilt, overborrowed, and eventually crashed. AI may follow the same pattern. The technology can succeed while many investments fail.

For dental practices, the lesson is simple. Do not buy AI because everyone else is buying it. Ask whether it actually improves diagnosis, reduces no shows, converts more calls, lowers labor, improves case acceptance, or produces a measurable return.

A great demo is not ROI.

The smartest practices will not use the most AI. They will use AI where it clearly improves care, workflow, patient communication, or profitability.

Are we using AI to build better dental practices, or just buying into the biggest technology race of our lifetime?

10/16/2026

Episode #1743 : Dentistry Uncensored with Howard Farran, Howard sits down with the leadership behind DOCS Education — Dr. Michael Silverman, co-founder and President, and Dr. Anthony F**k, Dean of Faculty.

Between them, they’ve taught over 40,000 dental professionals how to safely implement sedation and treat the high-anxiety patients most practices never reach. Add four decades of clinical experience, advocacy before state dental boards, and a passion for practice building — and this one covers a lot of ground.

🎧 A must-listen on sedation dentistry, patient safety, access to care, and reaching the patients who’ve been avoiding the chair for years.

Could Your DSO Malpractice Insurance Disappear? Most employed dentists spend more time negotiating production percentage...
10/16/2026

Could Your DSO Malpractice Insurance Disappear? Most employed dentists spend more time negotiating production percentages than asking who actually stands behind their malpractice insurance. Steward Health Care shows why that matters.

Steward used a captive insurer, TRACO, to cover malpractice claims. According to The Boston Globe, by mid 2024 TRACO reportedly had only about $3.5 million in cash while facing more than 500 malpractice claims. Former clinicians who believed they were protected are now facing legal bills, settlements and potentially personal judgments.

Prospect Medical Holdings offers a similar warning. It largely self insured malpractice exposure and promised to cover major losses before excess insurance would respond. After bankruptcy, some physicians discovered that the employer promising to defend them could no longer reliably do so.

There is no credible evidence that a major DSO is currently facing a Steward style malpractice collapse. But the same insurance structures exist in dentistry.

Large DSOs may use commercial insurance, captives, self insured retentions, Risk Retention Groups, or layered combinations of these. None is inherently bad. The issue is whether the structure is adequately funded and who is actually obligated to pay when a claim arrives.

Dentists should know the legal insurer, whether the employer retains part of the risk, who funds the deductible or self insured retention, when excess coverage begins, whether defense costs reduce limits, who pays for tail coverage, and what happens if the employer restructures or becomes insolvent.

Tail coverage solves a claims timing problem. It does not solve insurer insolvency. Likewise, a promise to “defend and indemnify” is only as strong as the organization making that promise.

The lesson is due diligence, not fear. “Malpractice insurance provided” should no longer end the conversation. If your employer failed financially tomorrow, who would defend you for the dentistry you performed today?

Dental Foreign Body Aspiration: How a Missing Tooth Root Led to a Lung Lobectomy. A 53 year old woman underwent extracti...
10/16/2026

Dental Foreign Body Aspiration: How a Missing Tooth Root Led to a Lung Lobectomy. A 53 year old woman underwent extraction of her remaining 20 teeth under local anesthesia and nitrous oxide. During the procedure she experienced coughing and a choking sensation, but nothing appeared immediately catastrophic.

Weeks later, a persistent cough led to chest imaging. A tooth root was found lodged in the left lower lobe bronchus with distal atelectasis. Bronchoscopy failed to retrieve it, and she ultimately underwent a left lower lobectomy.

The malpractice case was never decided on the clinical merits. The first lawsuit used a dentist rather than an oral and maxillofacial surgeon as the expert witness and was dismissed. The case was refiled with an OMS expert after the statute of limitations had expired.

For dentists, the bigger lesson is recognition. Dental aspiration is rare, but it can be serious. Most misplaced dental objects are swallowed, not inhaled. Yet when adult airway aspiration does occur, teeth and dental prostheses are well represented. In one multicenter study, teeth accounted for 37.7 percent of airway foreign bodies.

The danger is that aspiration may not look dramatic. A patient can remain comfortable, leave the office, and later develop cough, pneumonia, or atelectasis.

So the key question is not simply whether the patient coughed. Patients cough and gag all the time. The key question is: Is anything missing? If a tooth, root, crown, bur, implant component, file, or screw disappears and cannot be accounted for, do not simply assume it was swallowed. Stop, document what happened, and arrange prompt evaluation when aspiration cannot be excluded.

Bronchoscopy successfully removes about 90 percent of adult airway foreign bodies in published series. Earlier recognition generally preserves more treatment options before inflammation, obstruction, and lung damage develop.

The event is rare. The consequence of missing it may not be. When something disappears during treatment, how certain are you that you know where it went?

Congratulations to Dentaltown member Thomas M. Paumier, DDS, as he begins his presidency of the American Dental Associat...
10/14/2026

Congratulations to Dentaltown member Thomas M. Paumier, DDS, as he begins his presidency of the American Dental Association. His leadership philosophy emphasizes listening, collaboration and strengthening the profession.

An Ohio State dental graduate and longtime Canton practitioner, Dr. Paumier credits mentors and organized dentistry with shaping his career. His involvement helped him contribute to clinical guidelines and develop expertise in antibiotic stewardship, demonstrating how practicing dentists can influence national policy.

He wants the ADA to concentrate on its essential responsibilities: advocacy, science, standards, ethics and practical resources for dentists. He also emphasizes a strong tripartite structure, connecting the national ADA with state associations and local dental societies. His approach to strategic planning welcomes different perspectives and challenges assumptions.

Educational debt, insurance pressures and threats to the doctor-patient relationship remain major concerns, particularly for younger dentists. Dr. Paumier sees supporting the next generation and strengthening connections between oral and overall health as important opportunities. His presidency will also coincide with an organizational evaluation expected to deliver recommendations in January 2027.

We congratulate Dr. Paumier and wish him success in serving dentists and their patients. American Dental Association AzDHA Arizona Dental Association Arizona Dental Association Central Arizona Dental Association

10/14/2026

Episode #1742 : Dentistry Uncensored with Howard Farran, Howard sits down with Tobi Bosede — AI and machine learning leader, founder & CEO of DentalFynd, and founder of People of Color in Dental.

Before dentistry, she built production AI systems for Fortune 500 companies that generated billions in revenue and multiple patents. Now she’s tackling the biggest AI question in dentistry right now: where does it actually create an advantage, and where is it just a label everyone’s slapping on things?

From GEO (the new AI-driven SEO — patients searching for dentists in ChatGPT instead of Google), to patented AI quality scoring, to whether AI will ever outsmart the humans who built it — this one goes deep.
🎧 Essential listening for any dentist trying to separate real AI value from the hype.

How AI Health Advice Is Changing Dental PatientsAI is already shaping what patients believe before they sit in the denta...
10/14/2026

How AI Health Advice Is Changing Dental Patients

AI is already shaping what patients believe before they sit in the dental chair.

A 2026 KFF poll found that 32% of U.S. adults had used AI for health information or advice. Patients may ask ChatGPT whether they need a crown, whether fluoride is safe, whether a root canal is necessary, or whether an implant is better than a bridge.

By the time they see you, they may already have a diagnosis, treatment preference, price expectation, and opinion about risk.

If a patient says, “ChatGPT told me I don’t need this crown,” don’t dismiss it. Ask what they were told, explain what the AI could not see, and show the patient-specific evidence from the exam, radiographs, photos, and scans.

The strongest answer to generic AI advice is not authority. It is evidence.

AI is not replacing the dentist. But it is increasingly arriving at the appointment first.

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9633 S 48th Street, Ste 200
Phoenix, AZ
85044

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