Wrapping this one up from Costa Rica. Not a bad office. Photo credit to my new wife, Shauntelle McGaw.

Pick any channel and someone in dental is sharing their opinion or perspective. Social media, podcasts, conference stages, newsletters. The information has never been more available.

One thing all of these voices have in common, whether they'll say it out loud or not, is that especially now, when it comes to technology, none of us can predict the future.

Things are moving at a speed that has no precedent in dental tech, at least not in my 20+ years of it.

It's not just dental tech though, it’s everywhere. Recently my Lyft driver pitched me his new app on the way to the airport last week. That's where we are in today's world of building tech, everyone can build a product and be a founder.

Seed the South runs an annual event focused on founders. In 2025 they had around 150 people in attendance. This year, according to Corient's, Brett Covert who was in attendance, it was over 700.

It seems that all those ideas people have had for years are finally getting built. When it comes to building a technology product, the barrier to entry has never been lower.

More technology companies means better products, right?

That doesn't seem to be the case. This makes figuring out what you evaluate, how you evaluate it, and the steps to implement it that much more difficult.

Whether we've chatted in person or you've read my writing I've always freely admitted something.

I've never sat in the seat as a true operator of a dental practice or DSO. I've worked hard and been lucky enough to gain access to many conversations and environments, learned everything I can about diagnosing problems and finding the right technology solutions, but that’s a gap I've always been honest about.

So this month I decided to hand the mic to two people who have lived it.

I wanted this article to be something you could take and use yourselves inside your private practice, group, DSO or even your vendor business as you're improving your onboarding experience.

The two individuals I chatted to about this topic are Dave Salciccioli, someone who has sat in a seat as a COO at an emerging group and VP of Operations at a 40+ location DSO.

The other is Caitlin Zulfic, someone that has worn nearly every operational hat inside a practice or DSO, most recently as a VP of Operations of an emerging DSO.

Here's what they said.

Decision vs. Execution

When I start working with a DSO, one of the first things I ask is to speak with people at every level who are truly using the tech.

Understanding how it’s performing from all angles inside the business matters. In many cases the answers I get from leadership versus the people using the tech every day are vastly different.

Dave has seen this play out first hand.

"Leadership has already moved on after they agreed to adopt the new tool. Rarely do they have time to come back on use and adopt."

What gets left behind are workarounds nobody fixed and roadblocks nobody came back to solve.

Caitlin was more direct which is no surprise to those that know her. In her experience the buy in conversation is rarely what it sounds like.

Two people, different organizations, yet the same answer.

When evaluation and implementation break down, it's rarely one sided. The DSO and the vendor both have a role in it.

Caitlin has seen this pattern consistently from inside the DSO.

Leadership alignment on technology is harder than most organizations want to admit. Competing priorities create confusion around delegation and nobody clearly owns the initiative.

On the vendor side it's no different.

Caitlin points out that vendors fall short on delivering on expectations. There's over-promising and under-delivering.

"Onboarding is clunky and long. The switch from sales to the onboarding team is a drop off. The relationship is so close with the sales rep that's often why the tech was chosen in the first place. Then onboarding doesn't seem to have the same information the sales team had."

Dave breaks down what that looks like operationally inside a DSO.

No real internal champion, no clear project team, overpromised timelines. A lack of clarity around deliverables from the start, a post sale timeline that's never long enough, and nobody driving action items on both sides.

"Without those things in place," he said, "things fall apart."

The pattern is consistent. A decision gets made by leadership, ownership gets murky, and the gap between what was sold and what gets implemented widens from there.

Before You Agree

Implementing technology has never been easy inside a private practice, let alone a DSO.

Things are constantly changing these days with new vendors entering the market every week.

Venture capital money, venture studio entries, and angel investors backing doctors building their dream app. It's tougher than ever to evaluate and adopt the right technology solutions because there are just so many.

So how do you protect yourself before you commit?

Dave keeps it simple. Ask how many customers are currently on the platform and for how long. Ask to speak to one of them directly before you sign anything.

Caitlin adds a layer of caution around the language vendors use during the sales process.

"Pay attention to 'we are going to have' or 'we are developing.' Chances are that enhancement isn't coming anytime soon."

She learned this firsthand. When evaluating a vendor, she told the rep they couldn't move forward until the platform supported a specific feature requirement. Two days later he came back and said it was live. They rolled it out, showing the influence of a DSO on product development.

Dave's questions to vendors could cut a bit deeper.

Most operators never ask either one.

Caitlin rounds it out asking questions about after the sale.

"What support will I have after onboarding? Who is my go to for issues? Can I speak to them before we sign?"

There is one more layer that I believe should get attention before contracts get signed. Security and compliance.

As new technology enters the market the bad actors follow. The same excitement around a new platform or tool exists on the other side of it too. Make sure you align with the right companies to protect your data before you add anything new to your stack.

Before you sign, know if your data is protected.

The questions you don't ask before you sign are the ones you'll be answering for months afterward, if the tool doesn't end up in your tech graveyard first.

Who Owns It

So much of technology working inside dentistry has nothing to do with the technology itself. It's about the people.

Their mindset, excitement, passion, and buy in. Without the right people driving it, even the best solution is destined to fail.

Integration matters and certainly ease of use matters too. The reality is none of it works without the right people in place to drive adoption and see it through.

Dave is clear that it doesn't have to be about a title. "A systems thinker who is organized and can galvanize their peers to be engaged and accountable long term."

He's equally clear about what happens without leadership backing it. "Without continued support from the top it will be dead in the water."

Caitlin takes it a step further. She believes in both the person and the title.

Alignment has to come from the very top to support whoever the champion is.

She also believes in local champions at the practice level. "It doesn't need to be the office manager. It can be anyone with enthusiasm for the tech."

On the vendor side the same principle applies.

Dave puts it directly. Sales has to care about lifetime value not just closing the deal. "There absolutely has to be a clear and intentional handoff from sales to implementation."

Caitlin agrees. "If sales reps are only compensated to care about closing the deal and not the life of it, they won't be interested in the long term success of the customer."

Two sides of the same problem. The DSO has to find the right person to drive it internally and the vendor has to care enough to see it through after the contract is signed.

When both happen the chances of success go up dramatically. When neither does, you already know how this ends.

Beyond Go Live

As discussed, there are a lot of voices in this industry talking about problems. You see it in newsletters, on social media, and on conference stages.

High level observations, big picture challenges, but rarely anything you can take back and use on Monday morning.

My aim has always been to be different with my approach.

Another consistent thing Dave and Caitlin came back to was that training is not an event, it's a process.

Dave put it simply. Vendors and DSOs need to stop treating speed as a virtue when it comes to implementation. "Continued small dose training over a longer period is more effective for learning and mastery."

Getting to go live faster doesn't mean anything if nobody knows how to use what you just turned on.

Caitlin builds on that with something more structural. The implementation team and ops need to be meeting regularly, tracking performance, and tackling underperforming offices together.

She points to the model Align Technology created with consistent rep to provider support as the example. "That same relationship needs to be established with any tech."

Lastly, there's the capacity question. How much can one organization realistically take on at once?

Dave's answer was one of the more memorable things either of them said. "It's like chubby bunny. One more marshmallow and you are going to choke."

Managing how many concurrent implementations you have running at any given time isn't a nice to have, it’s really a survival skill.

Caitlin adds in the human layer. As AI reshapes the technology conversation, some companies have pulled back on their implementation and onboarding teams assuming the technology will carry the weight.

She disagrees. "Human connections are still winning over tech any day. It's why we don't use bots to sell products."

What's Next

I asked both Dave and Caitlin the same final question. Is the industry getting better at this or just busier?

Neither of them sugarcoated it.

Dave was direct. "This has gotten way harder. There used to be market leaders but it's too complex now."

He could name ten RCM vendors right now that each approach the same problem differently. The options haven't made decisions easier. They've made them harder.

Caitlin went further. "It's getting worse. There's so much tech. DSOs are still operating in their own silos and piecing together tech stacks that work for them but don't work for the next affiliation they try to do."

She also called out something worth paying attention to. The hype around AI reducing jobs pushed many organizations to pull back on customer support too soon. "We are seeing now that's not going to happen anytime soon."

So what does better look like?

Dave laid out a framework worth keeping.

Caitlin brings it back to something simpler.

"It's not drop and go. It's not force it to the front lines. It's coaching, helping, improving, and growing together. Both sides have to care about the other's interests."

Between the demo and the outcome there's a stretch of road that too often gets left unmanaged. The conversations in this piece are a good place to start.

Schedule some time with me at this link.

Also, please check out Relay, a new business supporting the gap between technology implementation and operational performance.

A Note of Thanks

This piece wouldn't exist without two people who gave their time and experience generously. I'm grateful for both of them.

Dave Salciccioli is the CEO and Co-founder of Relay. He has spent nearly a decade in executive operational roles inside DSOs, most recently as VP of Operations at Shared Practices Group and Chief Strategy Officer at Singing River Dental Partners. His work has always centered on execution and making sure technology investments translate into real operational results.

Connect with Dave on LinkedIn.

Caitlin Zulfic is the Founder of Fox and Lotus Consulting and an Integrations Partner at Relay. She started at the front desk of a dental practice nearly 20 years ago and has held nearly every operational role in the industry since, most recently VP of Operations at Areo Dental Group. She now works fractionally with dental organizations helping align people, process, and technology.

Connect with Caitlin on LinkedIn.

The DSO Technology Show

Brian Colao and I sat down with Ali Hyatt, Chief Customer & Growth Officer at Henry Schein One, to talk about the direction of Henry Schein One, the shift toward a more customer-focused experience, and how they're listening to customers as they continue evolving their products.

One point I found especially interesting was the discussion around leadership and how the direction of the organization is being shaped from the top down.

HIGHLY recommend this episode to learn directly from HS1 on how they see their products impacting DSO’s at scale.

👉 Watch the episode here

DSO Compass Off Script

Clayton Russell and I welcomed our first guest to DSO Compass Off Script, Dave Salciccioli, co-founder of Relay, for a conversation on technology implementation and why so many projects struggle to deliver the impact organizations expect.

The discussion covered AI adoption, internal development efforts, vendor alignment, pilot programs, integrations, and why speed to impact is becoming one of the most important metrics DSOs are evaluating.

This is a REALLY great listen as well, highly recommend it if you struggle with technology adoption.

👉 Listen on Spotify, Youtube & Apple Music

Truly appreciate you being here and making it to the end. Have ideas, questions, or tech you want me to explore? Just reply to this or book some time with me to discuss.

- Matt