Dr. Richard J. Rosato

Restoring faith, hope, and implants with the help of Specialty1

Tell us about yourself and your practice.

I am a native of New England, born in Revere, Massachusetts and later raised in the town of Danvers (both just outside of Boston). I graduated from St. Anselm College in New Hampshire, a small, liberal arts college that really imbued in me a sense of community as well as my critical analysis, public speaking, and listening skills (among others). I took the lessons learned from “St. A’s” to Tufts University School of Dental Medicine, which is located in Boston. After graduating from Tufts (where I met my wife, Laurie), I moved to another big city — Chicago — where I completed my residency in oral and maxillofacial surgery, before moving home to New England, first to Rhode Island and finally, the state in which Laurie and I have raised our three children, New Hampshire.

My practice, Capitol Center for Oral and Maxillofacial Surgery, PLLC, is an embodiment of my educational and personal journey. My team is my extended family — we are here for each other in good times and challenging times. Our three offices are there to help the community. The challenges of the pandemic and the workforce shortage have had a great impact on care utilization, causing appointment delays and other issues. Wherever my team and I can help patients —particularly during emergencies — we are ready, willing, and able to step up to lend a hand.

What originally attracted you to the implant specialty?

Dentistry is an integral part of medical art. It inspires great passion in those who practice it even in the most general arenas. But it also stimulates an interest in delving further into that art’s many dimensions. Implant dentistry is one such arena, one that utilizes cutting-edge technologies that were not available even in the last decade. In that regard, for an oral surgeon like me, the promise and possibility of implant dentistry is truly exciting.

For me, my initial training in dentistry, coupled with my personal desire to provide care for those who may not otherwise be able to find help, led me to explore implant dentistry and oral surgery on the whole. Some of the patients we see in my practice are far beyond the need for a filled cavity or root canal — they need a full oral rehabilitation. A patient in this situation can become emotionally defeated, knowing that their road back to positive oral health could be a long one. Then again, when the patient sees how the latest in implant dentistry restored their smile and their health, their sense of faith and hope is also restored.

What is your biggest challenge as an implant specialist?

I operate practices in two rural areas (one of which is a dental health professional shortage area) of New Hampshire. The biggest challenge, therefore, is affordability. In New Hampshire, many of our underserved patients are also recovering from addiction, and their mouths are as ravaged as their income. They are aware of the great esthetic promise of implants. However, for many of them, the possibility of a fully restored smile through implants seems a distant reality.

I was taught at an early age that when you believe in something, you find a way to make it happen. I believe in helping my patients, so if implants are not presently affordable, a solution is needed. In New Hampshire — as is the case across the country — our first step has been to work with the state to identify the most vulnerable patients in need of implants. Over 2 decades, I worked with the New Hampshire legislature to pass our first adult dental Medicaid benefit, which came into being just a year ago. Now, we are collecting the data and zeroing in on those patients who need implants so that our state can support their need for care. Meanwhile, most dentists in New Hampshire — even those who do not presently take Medicaid — work with veterans, seniors, and recovering addicts to put them on the road to recovery, even if doing so means donating chair time and resources.

“A clear and well-oiled business operation, such as that which I have built with the help of Specialty1 … enables me to focus on patient care, including exploring and using the latest in implant technologies.”

What prompted you to partner with Specialty1 Partners?

All dental practices need to maintain their clinical autonomy while managing financial and business operations. Oral surgeons also have these needs in addition to our own more specialized requirements. However, as a relatively small professional population, oral surgeons do not always have the resources available to meet these needs.

Then again, with Specialty1 Partners, an oral surgeon like me can access a wealth of resources in one place. We are able to obtain information on business operations like marketing, human resources, training, billing, and much more. The best part, for me, is that these resources are gathered by dentists and oral surgeons like me so I know what they offer is what I need.

How has the business side of your practice before and after your partnership with Specialty1 changed?

In a fast-paced and intensive practice like mine, it is critical that our protocols and systems are clearly available for the team and easily accessed. Our partnership with Specialty1 came just as my practice operations expanded, which means new people and new systems. The presence of Specialty1 within my practice helped make this expansion simple and transparent for my entire team. Human resources, training, accounts payable and receivable, and other crucial systems are running smoothly even with new personnel.

What implant platforms or systems do you use?

I use Straumann^® BLX, ZimVie, and Astra/Dentsply implant systems.

What is genuinely new in implant dentistry today?

I would say that some of the latest in dental imaging technologies are taking us in new directions with regard to implants. Cone beam imaging, for example, gives us a 3D scan of bone and tissue that is amazingly detailed — it truly enhances our ability to perform implant surgery effectively. Additionally, the increased application of artificial intelligence in implant dentistry has the potential to transform treatment and patient outcomes.

From a bone preparation standpoint, such things as patient-specific bone grafts as well as biologics have created scientifically based, reliable outcomes.

What is the future of implants?

As I mentioned, AI is helping to dramatically evolve implant dentistry. The algorithms employed by these systems could dramatically improve diagnostics, treatment planning, and long-term patient care. Of course, the future of implants is also its affordability. In rural areas like some of those in which I see patients, access to implants has always been a financial challenge, leading to a “haves versus have-nots,” or more precisely, a “dentures versus implants” dynamic. Then again, with the technologies used in implants becoming more readily available and therefore more affordable, it may be possible that more patients will be able to enjoy the long-term benefits of implants.

How did you first learn about Specialty1 Partners?

I first learned about Specialty1 through a colleague when I mentioned that as a solo practitioner I was feeling the stress of the administration becoming a burden and creating a level of unhappiness. He mentioned Specialty1 Partners as a dental partnership organization that allows group administration process sharing while maintaining clinical autonomy. This seemed to be exactly what I was hoping for and it turned out to be just so.

Are you concerned about the increasing presence of Dental Service Organizations (DSOs) in the dental market?

Dental Service Organizations (DSOs) are just one of a wide range of diversifying practice modalities. Their structure and “corporate” dynamic is certainly different from the more traditional “brick-and-mortar” private practice, just as is a public health dental clinic, FQHC, or large group practice. To me, a dentist is a dentist — an absolutely essential figure in a patient’s overall health — regardless of where they practice. In New Hampshire, DSO dentists abide by the same ethical standards, practice rules, laws, and license requirements that I do. Dentistry is not the same as medical healthcare — many of us must form and operate small businesses. As a result, the business of dentistry can appear in many forms. There are many positives of each dental practice model, and the future of inclusion in the dental profession will be acceptance of all models and then working to allow the positives of each to span across each model and provide advantages.

Are there any positive developments within the DSO landscape that you find promising?

In my work within organized dentistry — through the New Hampshire Dental Society and the American Dental Association — advocacy is a common ground between the many different dental practice modalities. Every dentist struggles with workforce challenges, dental student debt, continuing education requirements, dental benefit contract issues, and changes to state and federal law. I have found that DSOs are increasingly willing to work with other groups — like the ADA — on advocating in state capitols and Washington DC. With one voice, we are seeing more success in legislatures across the country than we might have with many smaller and disparate voices.

What is your future goal clinically?

I love dentistry. It can be a challenging field in which to work, but the rewards — especially knowing I am helping restore and maintain the oral health of my patients — are immeasurable. Clinically, I want to continue building a network in which I can see as many patients as I can in a state that, frankly, needs oral surgeons. A clear and well-oiled business operation, such as that which I have built with the help of Specialty1, is absolutely essential to that clinical goal. It enables me to focus on patient care, including exploring and using the latest in implant technologies.

What are your hobbies, and what do you do in your spare time?

I am an avid golfer, spending as much time on the links as I can in the warm months. I am also a passionate hockey fan after playing all of my life, rooting for my Boston Bruins — even when they fall short. Above all, I love my family. Spending my free time with my wife, Laurie, my grown kids, and of course, our goldendoodle Roma, keeps me grounded and smiling every day.