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April 10, 2024
Laura McClintock

From Jawbreakers to Rule Breakers 


Imagine you’re in front of the bathroom mirror, feeling a vague sense of panic. You’re seeing the dentist today. You start brushing your teeth and remember with a sense of dread that it’s been a while since you last flossed. Will one thorough session make up for 6 months of absent-mindedness?   

You finish brushing and get ready for the guilt trip from your friendly dentist. Your stomach churns. It’s only 2 hours until your annual checkup. 

And you’re not alone.  

Dentavox, an industry market research platform, surveyed 18,000 people globally and found over 60% of people suffer “dental fear”. The Journal of Oral Rehabilitation found only 9.5% of people say going to the dentist is a relaxing experience, reinforced by an average dentist NPS score of 1 – lower than our airlines. 

What if dentist appointments weren’t so anxiety inducing? 

In October 2019, a dental start-up called Tend came on the scene with the express intention of disrupting the oral hygiene industry. Their goal? To make you “look forward to the dentist”.  

The inspiration? Sitting in the dentist waiting room in 2018, Doug Hudson saw a broken chair. It was his second visit in a month and his bills were rising. He was shocked. With the amount patients were paying, the office hadn’t fixed this chair. They hadn’t considered the customer experience. With a background in launching and leading orthodontic start-ups (Smile Direct Club), Hudson decided enough was enough, he could do this better. Tend launched a year later with a customer-focussed ideology and beautiful Instagrammable spaces to round out the experience. 

It’s a classic market disruption case study - looking at where current products don’t meet consumers’ needs and improving it. But the trick isn’t just in coming up with a big idea, as Harvard Business Review’s “What is Disruptive Innovation” article points out, “smart disruptors improve their product and drive upmarket”. 

Tend broke the mould for good. 

At its core, Tend is a dental clinic, but they don’t look it. When you enter one of their clinics you’re greeted by a space that looks more like a luxury health spa than a dentist. To get the look, Tend built a ‘Brush Bar’ filled with hand-poured marbled basins and Spanish tiling with floss-like line details. Every detail considered and carefully crafted. 

With the goal of building a recurring customer base, rather than upselling one-off appointments, Hudson set out to address 3 pain points for Tend customers.  

Vague pricing, specialist referrals (which often come with a hefty fee) and the lacklustre customer experience. So, customers were told upfront how much their appointment would cost based on their insurance, and Tend kept all specialities in-house. 

Can you make someone enjoy the dentist?  

Tend staff are trained to be welcoming, upbeat and friendly. Your suite is personalised with a welcome message when you arrive. Netflix and Bose noise-cancelling headphones are provided while your teeth are cleaned. Plus, the space looks like a spa. 

Everything is automated, from x-rays to billing and new appointments. Outside of their appointment, patients can manage their own oral care from their phone.  

Tend’s ad campaigns also celebrate not only racial and gender diversity but diversity of teeth! Chips, caps, braces, crooked and crossover, Tend showed them all.

No pain, no shame. 

Tend’s dentists never humiliate or chastise their patients. If you want to eat hard candies or any treat that could harm your teeth, then that’s ok.  

Hudson understood that as service providers, dentists were there to support patients’ oral health, not dictate it. He understood that we should be able to live our lives and not have to feel the repercussions every 6 months at the dentist.  

This customer-first approach has led Tend to an appointment no-show percentage that is one third of the industry average. Tend’s NPS score also blows away the industry average of 1, sitting comfortably at 85.  

Since launching in 2019, Tend has raised $200 million and had 100% revenue growth, opening over 23 locations in the North-East United States. Proving that sometimes breaking rules is the sanest thing you can do in business.


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