Dr. Sameer Puri, chief clinical officer (CCO) at Imagen Dental Partners, organized the first gathering exclusively for dental service organization (DSO) CCOs with one request: Everyone must be brutally honest.
The two-day meeting took place on April 16 at Imagen's headquarters in Scottsdale, AZ, and drew clinical leaders from across the U.S. to tackle shared challenges in hygiene, associate development, clinical autonomy, and artificial intelligence.
Dr. Puri shares why he created the CCO Inner Circle meeting and why he thinks it is just the start of a much-needed conversation among dental providers.
Creating the first-ever meeting for DSO CCOs
Dr. Sameer Puri stands next to the CCO Inner Circle 2026 Clinical Alliance Council event in Scottsdale, AZ.Beth Gaddis/Planet DDS.
When Puri joined Imagen as CCO, he found himself without a peer community.
He had spent 30 years in dentistry, spanning private practice, dental education, and lecturing, but the group practice world was new territory. With encouragement from his CEO, Rezwan Manji, and support from dental industry partners Planet DDS and Overjet, Puri compiled contact lists and started texting clinical officers he had never met.
"We thought, 'Hey, let's get 10 people in a room and have a good conversation,'" he said. "We ended up having about 30 chief dental officers."
Leading through conversations, not presentations
The agenda grew directly from pain points Puri's organization was navigating. He also made a deliberate choice to avoid the standard conference format.
"What I didn't want to do was to assign speakers where you put together a PowerPoint and we listen for an hour," he said. "There were too many smart people in the room to not hear from everyone."
Each session ran about an hour, with one attendee framing a topic before opening the floor. A presentation by Wave Dental's Dr. Steven Wingfield on hygiene and scaling and root planing sparked one of the meeting's most focused exchanges, with the consensus being that organizations need a clear, top-down protocol with no ambiguity when it comes to periodontal disease diagnosis and treatment.
"There should be no confusion," Puri said. "Put in whatever parameters you need to put into your organization and treat what comes out of that."
Attendees of the inaugural CCO Inner Circle meeting. A 2027 summit is planned, with smaller gatherings clustered around industry meetings.Beth Gaddis/Planet DDS.
Hygiene workflows, associate development spur new ideas
Hygiene was a hot topic. The group discussed doctor-led models, assisted hygiene, robotic hygiene, and the financial pressure dentists face around staffing costs. Puri noted that many organizations are rethinking the hygienist's role, including deploying dedicated assistants to handle setup and room turnover so hygienists can focus on higher-level clinical work.
"We're treating them like providers," he said. "We're treating them to the level of their credentials. We don’t expect a doctor to set up and clean up a chair, so why are we having a highly compensated, highly trained hygienist perform tasks that we don’t expect doctors to do?"
Associate dentist development was equally pressing. The group agreed that preparation coming out of dental school has declined sharply.
"We have dental students graduating that have never done a root canal," Puri said. "Maybe they've done two crowns."
For advanced procedures like implants, the CCOs agreed that you can’t just send dentists to a weekend course. Instead, they need mentoring and ongoing clinical support until they feel comfortable performing those procedures solo.
“Nothing beats hands-on training for learning how to place implants,” Puri said.
Clarifying what clinical autonomy means
Much of the discussion around clinical autonomy centered on distinguishing operational standardization, such as vendor selection, from actual clinical decision-making.
"We're not telling them what material to use or what to do on the tooth. You're just telling them, 'Here are the vendors we use,'" said Puri.
In his experience, doctors have largely welcomed that clarity. "Our doctors are relieved to have some preferred choices that are vetted by their clinical colleagues and partners."
Identifying where dental AI is most effective
AI ran as an undercurrent through multiple sessions, from diagnostic imaging to voice assistants to back-office automation. On the clinical side, the group discussed how AI tools can take subjectivity out of periodontal diagnosis. "Radiographic evidence of bone loss on Overjet, for example, is not going to be subjective," Puri said.
When rolling out new clinical initiatives, the group agreed that pilots should be doctor-driven.
"Anything clinical, it shouldn't be 'Doc, just go use it,'" he said. "It should be a well-vetted, well-researched, debated process."
Overall, Dr. Puri described the mood as pragmatic.
"AI is here to stay, and it's part of our lives."
The biggest takeaways from the first-ever CCO Inner Circle
For many attendees, simply finding a peer group was the point. One chief clinical officer said, "It was one of my favorite events I’ve gone to. The networking was excellent. We’re all dealing with similar issues, so learning from others in the same position was very valuable.”
For Puri, the value was as much validation as discovery. "It wasn't aha in terms of a new finding," he said, "but aha in the sense of, I've been saying this for six months or six years, and these other guys are having the same issues or have the same solutions."
What comes next for the DSO CCO group
Puri has created a communications channel to keep the group connected and is planning another full meeting in 2027. In the meantime, he is exploring smaller gatherings around conferences like Dykema and ADSO.
The response made the effort worthwhile. "It was very gratifying. We've got a great group, and we're certainly going to do more of it."
Beth Gaddis is the editor in chief at Planet DDS, a dental technology company specializing in cloud-based practice management systems, digital imaging, and dental marketing services. Previously, Gaddis was the marketing director for two large dental service organizations. Prior to entering the dental industry, Gaddis was a journalist for 16 years in a variety of roles, including as a TV news producer at the CBS affiliate in Boston. You can connect with Gaddis on LinkedIn.
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