From managing 100+ disparate lab relationships to driving same-store growth with a strategic partnership model.
Summary of Impact
Apex Dental Partners needed to consolidate their lab strategy from 100+ clinician-owned relationships, to a few trusted national lab providers.
They chose Dandy because they liked the emphasis on partnership, technology, clear clinical impact, and the zero upfront cost. Since choosing Dandy, Apex has been able to:
- Eliminate annual scanner CAPEX that previously ran into the tens of thousands of dollars
- Consolidate lab partnerships from 100+ labs down to a targeted 10.
- Increase practice efficiency through reduced chair time, digital workflows and fewer remake
- Attain zero remakes by several providers after a year of use
- Offer new revenue streams and increase ROI from previously unprofitable procedures like dentures
- Decrease remake rate by 29%
- Save >$1.5 million in intraoral scanner costs
- Reduce denture appointments by 50%
The Challenge
For Apex Dental Partners, a rapidly growing DSO based in Houston, Texas, lab consolidation was more than an operational necessity—it was a strategic imperative for sustainable growth.
With 60 offices across multiple states, Apex faced the classic DSO dilemma: how to balance clinical autonomy with the operational efficiency needed to scale. Each practice was working with three to seven different labs, creating a fragmented network that made it nearly impossible to leverage volume pricing, maintain quality standards, or gain visibility into performance.
“We had a lot of lab partnerships that weren’t national lab brands,” explained Dr. Michael Fooshée, Co-Founder and Chief Clinical Officer at Apex Dental Partners. “What we realized is that it led to some challenges as we grew beyond different markets and states.”
In between the first and second appointments, the Digital Design Preview was created (Fig. 2). Upon review and approval of the digital preview, a model was ordered. The model was used to make PVS stents for future reduction guides and eventual temporary crowns.
The fragmentation created multiple pain points that were limiting Apex’s ability to grow:
No negotiating power. “If we’ve got every single dentist choosing their own lab, we’re never negotiating on pricing because we never have a volume advantage,” Dr. Fooshée noted. Without consolidated spend, Apex couldn’t capture the cost savings their scale should have provided.
Operational complexity. It was impossible to consolidate billing processes with multiple lab partners. Each lab partner had their own invoicing processes creating difficulty for the Apex operations team.
Limited clinical support. The Apex operations team had limited ability to support their clinicians without a direct line of communication to the lab. In addition, they couldn’t rely on the labs to enable clinicians to provide high-quality work with fewer remakes.
Zero visibility. Dr. Brad Eller, Director of Clinical Development said, “I didn’t have a lot of interaction with the labs because there were so many different ones. I didn’t know who people were using. I had no way of really tracking as to how things were going. I had nobody I could give feedback to. I was out of the loop, basically.”
Perhaps most critically, this fragmentation was capping Apex’s growth potential. With practices requesting $40-75k scanners and no standardized digital workflow, capital expenditures were mounting while same-store growth opportunities were being missed.
The Solution
A Partnership Model Built on Clinical Autonomy and Strategic Alignment
Apex needed a different approach-one that wouldn’t alienate their providers but would deliver the operational benefits of consolidation. Their answer was a carefully curated lab portfolio that balanced national reach, clinical autonomy, and digital innovation.
That’s where Dandy entered the picture.
Dr. Fooshée explained. “The reason I ended up really pushing ahead with the partnership with Dandy was their focus on the technology component, which helps our clinical team support our doctors.”
But technology alone wasn’t enough. Dr. Layla Lohmann, Co-Founder and Clinical Director at Apex, was clear about their requirements: “I wanted to give our doctors guided choices, thoughtful choices.
We’ve done the research for them and been solution-focused.” They needed to provide clinicians with choices that made sense based on costs, services and ease-of-use.
WHY DANDY ALIGNED WITH APEX’S STRATEGIC VISION
Several factors made Dandy the right fit:
Shared values on partnership. “We share the same values,” Dr. Lohmann told the Dandy team. “You care about people, you care about education. You don’t just get mad at a partner if we don’t do it right the first time. It’s a collaborative approach.”
Technology-first mentality. “You’re really tech-driven, and I think in the industry now, those who are not tech-forward are going to be left behind at some point,” she emphasized. For a DSO positioning itself as “private practice reimagined,” staying ahead of the technology curve wasn’t optional.
Clear clinical value. Dandy’s value was strong enough that doctors wanted to adopt it. “I’m not having to sell the product to my doctors,” Dr. Fooshée noted. “Dandy’s already created a good business model that makes sense.”
Zero capital investment. With Dandy providing free scanners, Apex eliminated a major barrier to digital adoption while freeing up capital for other growth initiatives. The total value of scanners so far is $1.5m and rising. Dr. Eller says, “With other national lab brands you’re looking at $40,000 to $75,000 just to have a scanner in your office. The fact that there is zero cost to bring in a Dandy and you get a lab credit to try it out. It’s almost a no-lose situation.”
Implementation
Building Momentum Through Provider Buy-In
Apex’s approach to implementation reflected their philosophy of guided choice rather than mandated compliance. “We definitely have not taken the approach of just telling everybody what lab they use,” Dr. Fooshée explained.
Instead, Apex positioned Dandy as the obvious choice—backed by compelling value propositions:
- Free scanners to decrease the barrier to entry for clinicians
- Competitive pricing that leveraged Apex’s consolidated volume
- Superior support compared to other national labs
- Technology advantages including digital workflows that increase case acceptance
- Live chairside support for newer doctors and recent graduates
Dandy’s commitment to relationship-building accelerated adoption. “One of the things that stood out in the relationship-building process and the launch was Dandy’s willingness to invest in getting themselves in front of our doctors and teams,” Dr. Fooshée recalled. “That’s been impressive— their commitment to invest in the relationship from that perspective.”
Dr. Lohmann added: “When I’m speaking to skeptical doctors, I talk about how the technology allows faster communication. If I have a question about a fixed unit, I can get to Dandy a lot quicker than calling another lab on the phone. The accessibility is quicker.”
Results
Consolidation, Cost Savings, and Clinical Excellence
The partnership has delivered measurable impact across multiple dimensions of Apex’s business:
1. FREE UP CHAIR TIME TO SEE MORE PATIENTS
Dramatic reduction in denture appointments.
Dr. Lohmann completed her first dentures in seven years using Dandy’s digital workflow. “I remember it used to take me seven or eight appointments originally, and this took four. It really reduced the patient’s time away from their family and work.”
Even more impressive: “My dental assistant did 90% of it. All the steps can be done by a dental assistant if you train them right.”
Eliminated scanner bottlenecks. “I have a pretty consistent request for scanners from offices, and that’s essentially gone away because offices that have the request-Dandy is the answer,” Dr.
Fooshée explained. “It’s really cut out a lot of our requests and spend. Coming into the end of the year, we’d normally be collecting dozens of requests for new scanners, and that’s really gone away.”
Al-powered efficiency. Dr. Lohmann noted how Dandy’s Al margin detection saves time: “My dental assistants normally wait for me to mark all my margins. The last three cases, I haven’t double-checked the Al-generated margins, so it’s gained me time.”
2. TURN MORE TREATMENT PLANS INTO ACCEPTED CASES
Technology improves patient education. “We do wellness scans on all our new patients, and they get amazed at the technology we’re using,” shared one Apex provider. “Showing patients a scan of their teeth makes it easier to recommend treatment.”
Enhanced patient comfort. “The wand is smaller, so it helps with patient comfort for those with limited jaws and limited openings,” Dr. Lohmann explained.
Digital preview builds confidence. The ability to review digital wax-ups before production gives both clinicians and patients confidence in the final result.
3. EXPAND OFFERINGS TO CAPTURE MORE REVENUE PER PATIENT
Digital dentures unlock new revenue. “What’s exciting about this is that doctors are getting excited about doing dentures again, which is a very hard thing to do,” Dr. Fooshée noted. “Dandy’s digital denture workflow puts these at a price point that actually starts to make sense for the office again.”
Complex cases made accessible. Dr. Lohmann successfully completed a roundhouse bridge-“only my fourth in 14 years”—with Dandy’s support.
4. LEVERAGE DATA TO UNCOVER NEW GROWTH OPPORTUNITIES
Hub dashboard provides unprecedented visibility. “The Dandy Hub gives me one place I can go in and I can look at any doctor’s scan and prep. I can look at who’s getting remakes and why. I can see who’s ordering, who’s not ordering. It has simplified my part of the process greatly,” said Dr. Eller
Proactive clinical support. Dr. Eller highlights Dandy’s technology in helping new clinicians drive better results, faster, “I’ve been able to see some of the preps where they’re not getting the tissue before they take the scan. That leads to a direct conversation with them about what they could do differently or better to get better results. Some of those things would normally take five years of trial and error to figure out how to do them well. With Dandy we’re fast-tracking their progress and getting them to a point to where they get good results.”
5. BUILD A CULTURE THAT DRIVES ALIGNMENT AND GROWTH
Lab as team member, not vendor. Dr. Lohmann emphasized the cultural shift: “For any DSO relationship or clinician, I would ask them to think about any lab as a true partnership. Communication is vital before you throw people under the bus. Dandy is a great partner-it’s about moving away from how vendors are traditionally seen versus having a strategic partnership.”
Empowered dental assistants. “I really think communication within the team of what the lab needs from clinicians helps our dental assistants feel more confident in their career,” Dr. Lohmann noted. “If somebody wants more pay and career development, you’ve got to step up in those positions.”
Consolidated clinical support. By standardizing the majority of practices on Dandy, Apex created a replicable clinical support model that scales across their organization.
FINANCIAL IMPACT
- Saved >$1.5 million in intraoral scanner costs
- Eliminated annual scanner CAPEX that previously ran into the tens of thousands of dollars
- Consolidated lab partnerships from 100+ labs down to a targeted 10
- Increased practice efficiency through reduced chair time, digital workflows and fewer remakes
- Attained zero remakes by several providers after a year of use
- Offered new revenue streams and increase
ROl from previously unprofitable procedures like dentures
Looking Ahead
Continued Innovation and Growth
As Apex continues to scale, the partnership with Dandy remains central to their growth strategy.
“I’m excited that they continue to prove they’re not done innovating,” Dr. Fooshée shared. “Within four or five months, they’ve continued to innovate, which is exciting. I’m interested to see what happens next.”
ADVICE FOR OTHER DSOS
When asked what he would tell another DSO executive considering Dandy, Dr. Fooshée didn’t hesitate:
“It’s a no-brainer. If you don’t want to be in a position where you have to talk doctors into switching labs, this is the easiest pathway to lab consolidation. Dandy’s got the team to do it. They understand the approach that works, and they’ve got a track record of getting consolidation accomplished.”
Dr. Lohmann added, “If you want to learn with a lab on how to do things effectively, that’s the partnership I would recommend. They’re very easy to communicate with. You want to get in early with a company that’s growing so you can grow together and learn together instead of just switching lab after lab.”
Dr. Eller gave his own advice, “Explore the Dandy Hub. If you’re just in there to look at a scan, you’re missing out on so many different opportunities. There is a wealth of knowledge and information that’s in there if you take the time to go through.”
The Bottom Line
From Cost Center to Revenue Engine
For Apex Dental Partners, the partnership with Dandy has fundamentally transformed how they think about their lab relationships. What was once viewed primarily as an operational complication and expense is now recognized as a strategic lever for same-store growth.
As Dr. Lohmann put it: “Dandy is an organization that values education, technology, and people-three things in the healthcare industry that need attention.They help refocus on how to be solution-oriented and receive feedback well, then figure out a way to get you that next elevation or next solution.”
For DSOs facing the same pressures Apex encountered — slower M&A pipelines, margin compression, the need to drive same-store growth-the lesson is clear: your dental lab partner shouldn’t just be reducing costs. With the right partner, your lab can unlock new revenue, improve clinical outcomes, and become a true competitive advantage.
