From the inside out vs. from the outside in: strategic integration in dentistry

February 23, 2024

In the dynamic and highly competitive world of dentistry available in the private sector, the strategic management of a clinic can be approached in two different ways: “From the Inside Out” and “From the Outside In”.

Each of these approaches defines a unique way of organizing and delivering healthcare, influencing the efficiency of procedures and the sustainability of the clinic. This short reflection explores
both strategies, seeking to describe how they can complement each other to shape a resilient and customer-centric approach

Inside-Out Strategy

The Inside Out strategy focuses on maximizing the clinic’s internal capabilities. This approach underlines that the success of a clinic depends on optimizing its core competencies.

Aspects such as the qualification of the team, technologies, equipment and devices, quality of facilities and location are considered fundamental.

The idea is to create and leverage a solid internal infrastructure that can be designed to attract and retain patients. By focusing on internal strengthening, the clinic can offer high-quality services, reflecting them directly on customer satisfaction and the clinic’s reputation in the market.

Outside-in Strategy

In contrast, the Outside-In strategy in dentistry directs attention fundamentally outwards, i.e., to the needs and expectations of patients and the market.

This approach advocates adapting the clinic’s services and culture to patients’ demands, expectations, and desires. Here, the focus is on understanding and embodying what patients really want and need and how the clinic can respond to those expectations effectively.

The goal is to align the clinic’s offerings with the needs of the market, thereby creating a competitive advantage. A clinic that adopts this approach is constantly looking to innovate and improve its services, relying mainly on feedback and evolving patient preferences.

You can read the full article, in Portuguese or English, in the Portuguese monthly edition of Dentistry magazine:

Open the English version of the article (pdf).

Open the Portuguese version of the article (pdf).


Orlando Monteiro da Silva receives honorary doctorate from University of Porto

January 13, 2014

Orlando Monteiro da SilvaThe University of Porto conferment of degree doctor honoris causa to Orlando Monteiro da Silva, by proposal of the Faculty of Dental Medicine. It’s the first time that a dentist is recognised in Portugal.

With origins dating back to the eighteenth century, the University of Porto is currently one the most prestigious higher education institutions of Europe.

A public institution close to 32,000 students, 2,400 teachers and researchers along with 1,600 administrative staff attend its 15 schools and 60 scientific research units, spread across three university campuses located in the city of Porto.

With 14 faculties and a business school, the University of Porto provides an exceptional variety of courses, covering the whole range of study areas and all levels of higher education. In fact, offering over 600 training programmes per year (from degrees to continuous professional training), the University of Porto has teaching solutions for everyone.

The immediately previous distinguished was Jean-Claude Juncker in 2013. See all 79 contemplated here since 1921.

Biography Note

Orlando Monteiro da Silva was born in Porto and graduated in dentistry from the Faculty of Dental Medicine, University of Porto.

President of the Portuguese Dental Association since 2001, Orlando Monteiro da Silva has occupied several functions both in national and international prominent institutions.

In 2003 he was elected to the board of the Council of European Dentists, CED, having later served a mandate as its president, between 2006 and 2009.

In 2004, he was a candidate for the council of FDI – World Dental Federation, having become the first Portuguese person to assume decision-making functions within this global organization of dentistry. He promoted the adhesion of East Timor, Angola, Mozambique, Guinea-Bissau and the Lusophone Dental Association to the FDI.

University of PortoThe importance of advocating for Portuguese dentists and dentistry both nationally and internationally, as well as for the relevance of learning and of bringing experiences from abroad, have marked his work as President of the Portuguese Dental Association, Ordem dos Médicos Dentistas, regulatory body of the profession in Portugal.

In 2011 he acted as president of FDI – World Dental Federation, a position he occupied until the end of his term in August 2013.

In 2011, he was elected president of the National Council of Professional Associations (CNOP) and in 2012 he took office as councillor of the Portuguese Economic and Social Council, for four years from 2011 to 2015.


Madrid: Current practice of Dentistry in Europe

December 29, 2013

Last 21 December, by invitation of the Spanish Dental Association, I participated at the Round Table “Current practice of Dentistry in Europe” of the XXXIV Congresso Nacional e XIV Internacional do Consejo General de Colegios de Odontólogos y Estomatólogos de España.

Other colleagues, as Stefaan Hanson, Marco Landi, Catherine Mojaïsky, Philippe Rusca, Gerhard Konrad Seeberger and Michael Sereny had also contributed with their opinion and experience. The moderator was Juan Manuel Aragoneses and Manuel Alfonso Villa Vigil, president of the Consejo, was the host of this relevant round table.

The highlight and topics that were under discussion:

  • numerus clausus: limitation in the number of incoming student at university in EU;
  • number of Dental Schools;
  • number of students that begin Dentistry studies each year;
  • percentage of population that uses dental services;
  • percentage of population that goes to the dentist without a “perceived need” annually;
  • Funds and/or supports from Governments to dental services;
  • private treatments / kind of payments
  • Advertising

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From left to right, Andrés Plaza Costa, Manuel Alfonso Villa Vigil and Juan Antonio López Calvo.

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From left to right, Enrique Llobell Palanca, Premio Santa Apolonia, my wife, Manuel Alfonso Villa Vigil, Llobell’s wife and me.

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Press conference at Santiago Bernabéu Stadium of Real Madrid. Gerhard Seeberger, speaker at the round table too, interpellating a journalist…


Gracias Paraguay, hasta siempre!

September 15, 2013

Immediately after FDI AWDC 2013, in Istanbul, by invitation of the Circulo de Odontólogos del Paraguay (COP), I had the pleasure to attend, as FDI past president, the IX International Congress in Assuncion (5-7 September).

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Open ceremony – national authom of Paraguay.

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Colleagues from Paraguay.

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The FDI General Assembly in Istanbul approved the COP membership as Associate member. As the COP representatives couldn´t attend the Istanbul AWDC, so I had the honor to deliver it locally…

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With the president of the COP, Eduardo Poletti Paoletti.

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I took the opportunity to present in Spanish the Vision 2020 FDI project…

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Local organizing committee….

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Farewell: Noche tipica at the…

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….Head office. Gracias Paraguay, hasta siempre!


Ayubowan Sri Lanka!

July 9, 2013

By invitation of the Sri Lanka Dental Association (SLDA), I had the pleasure to attend the FDI-World Dental Federation/CDA-Commonwealth Dental Association/SLDA Joint International Conference, under the theme “New Challenges in Dental & Oral Care”, from 27th June till 1st July.

Simultaneously, the Sri Lanka Dental Association was commemorating its 80th anniversary. As stated by HE the President of Sri Lanka, Mahinda Rajapaksa, ”…80 years in valuable service to the country…”

Arrival of the Sri Lanka minister of Health, Maithripala Sirisena, at the ceremonial inauguration.

Arrival of the Sri Lanka minister of Health, Maithripala Sirisena, at the ceremonial inauguration at the Nelum Pokuna Mahinda Rajapakse Theatre. Maithiripala Sirisena, as chief guest, said: “ …Sri Lanka is a nation that can boast nearly a century of public dental service offered free of charge to its citizens. It’s the only country in the South East Asia region in which nearly 65% of the country’s dental surgeons are employed by the State…”

Traditional welcome ritual.

Traditional welcome ritual.

Addressing at the opening.

Addressing at the opening.

With Suresh Shanmuganathan, president of Sri Lanka Dental Association.

With Suresh Shanmuganathan, president of Sri Lanka Dental Association.

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From left to right, Me, Suresh Shanmuganathan, Dato Ratnanesan (president of Asia Pacific Dental Federation and FDI past-president) and Bill O’Reilly (president of the Commonwealth Dental Federation).

Dance performance at the opening ceremony.

Dance performance at the opening ceremony.

With local dancers.

With local dancers.

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Organizing committee group photo. Standing, from left to right: Sunil Gunaratne, Gamini de Silva, Pubudu Perera, SuniI Fernando, Manil Fonseka, Ruwan Jayasinghe, Mahim Wimaladharma, Dasun Perera, Lionel Dassanayake, Ganananda Nanayakkara, Miraz Mukthar, V. Thuthikaran and Douglas Perera. Seated, from left to right: Naresha Samarasekara, Nilantha Ratnayake, Malcolm Stanislaus, Asoka Amunugama, Ramesh Kanna, Suresh Shanmuganathan, Vipula Wickramasinghe, A. Sundar, J. M. W. Jayasundara Bandara and DiIini Wijesooriya.

Entrance of the congress centre.

Entrance of the congress centre.

Opening of trade exhibition. With Rajitha Senaratne, minister of Fisheries, and Suresh Shanmuganathan, president of the Sri Lanka Dental Association.

Opening of trade exhibition. With Rajitha Senaratne, minister of Fisheries, and Suresh Shanmuganathan, president of the Sri Lanka Dental Association.

Live, Learn and Laugh Symposium lecturing: LLL Global Health promotion Project-Global perspective.

Live, Learn and Laugh Symposium lecturing: LLL Global Health promotion Project-Global perspective.

My contribution was to briefly outline the role and operations of FDI, providing the global context for the national LLL programme. For her part, Vaidehi Ketkar, Unilever, described the LLL concept as well as its historic background.

Local project leader, Prasad Amaratunga of SLDA, provided an outline of the aims and achievements of the national LLL project, one of eight underway in Asia targeting schoolchildren.

The South-East Asia perspective was provided by Prof Prathip Phamtuvanit, LLL Regional Coordinator for Asia. He pointed out that, according to baseline data collected in Asia, the 11 LLL projects have reached out to at least 10,700 children and dental patients. The presentations were followed by 30 minutes of open discussion.

Symposium on “Integration and harmonization  of Oral Health”.

Symposium on “Integration and harmonization of Oral Health”.
Other intervenients: Bill O’ Reilly, Dato A. Ratnanesan, Lanka Jayasuriya Dissanayake (WHO – Sri Lanka professional officer).

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Press conference.

Press conference.

High coverage at local media.

High coverage at local media.

Some data of dental medicine in Sri Lanka:

2000 (approx..) dental surgeons
1420 in public sector
Population around 21 million habitants
DMTF 5 years prevalence in 2002/03 : 3.6
Number of dental medicine faculties: 1 Peradenya

In Sri Lanka, the national oral health policy has been drafted in accordance with the national health policy. Its implementation will ensure the oral health care services are integrated with the medical services.

The first Europeans  to visit Sri Lanka, in 1505 (Portuguese Ceylon as they called it) were Portuguese, as we can still feel by the “da Silva brotherhood…”

The first Europeans to visit Sri Lanka, in 1505 (Portuguese Ceylon as they called it) were Portuguese, as we can still feel by the “da Silva brotherhood…”

Elephant orphanage in Pinnawala.

Elephant orphanage in Pinnawala.

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Elephants teeth...

Elephants teeth…

Sacred Temple of the Tooth Relic in Kandy.

Sacred Temple of the Tooth Relic in Kandy.

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Peradenya Botanical Gardens, history dates as far back as 1371…

Peradenya Botanical Gardens, history dates as far back as 1371…

Running in the sea front of...

Running in the sea front of…

Galle Face Drive...

Galle Face Drive…


FDI African Strategy for Oral Health

July 2, 2013

The FDI World Dental Federation has defined a strategy for the development of Oral Health in Africa, which can be find on this pdf document.

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Turning Vision 2020 into an action plan – Chicago/ADA

February 23, 2013

The taskforce Vision 2020 met in Chicago at the American Dental Association (ADA) headoffice.

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We thank the ADA for all the collaboration and support.

From the FDI – World Dental Federation, the participants were Orlando Monteiro da Silva (president), Kathryn Kell (treasurer), Patrick Hescot (concilor), Gerhard Seeberger (councilor), Jean-Luc Eiselé (executive director) and Emmanuel Chevron (associate director). From the International Association for Dental Research (IADR), were Michael Glick and David Williams (IADR).

And industry partners: Christian Brutzer (Ivoclar), Gerard Meuchner (Henry Schein), Robert Labella (Johnson&Johnson), Mike Butler (Colgate), Analia Mendez (Unilever), Mayumi Kaneda (Sunstar), Friedrich A. Herbst (IDM).

This was a great opportunity to share ideas and suggestions for an operationalisation of Vision 2020 in the months and years to come.

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At the Chicago’s Millennium Park, with “The Bean” behind


أشكرك أيتها المملكة العربية السعودية ، القصيم. Thank you Saudi Arabia!

February 15, 2013

The city of Buraidah has always had the honor to host the event. This year, the fifth Dental students scientific meeting (5th DSSM) was held at the King Khalid Cultural Center.

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As guest speaker, I had the pleasure to present to a vast audience the FDI Vision 2020, shaping the future of oral health. Afterwards I responded to several questions placed by the students.

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Receiving, on behalf of the FDI, an recognition award under the auspices of honor if his Royal Highnness, Prince Dr. Faisal Bin Meshal Al Saud, also vice Governor of Qassim Province.

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Thanking on behalf of the FDI.

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With Mohammed Almohaimeed, dean of the College of Dentistry Qassim University.

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With Yousef Al-Khodair, Kingdom of Saudi Arabia National Board Health Affairs.

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During a scientific session.

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Addressing the audience about the FDI role on “Leading the world to optimal oral health”.

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Omar Al Abood, a saudi dental student, translating an interview for a nation tv channel.

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Students at the dental exhibition.

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Tower City Buraidah. Buraidah is the capital of Al-Qassim Province in northcentral Saudi Arabia in the heart of the Arabian peninsula. Buraidah lies equidistant from the Red Sea to the west and the Gulf to the east. It has a population of 609,000 (2010 census).

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Informal meeting with several dental students associations from Saudi Arabia.

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Irina F. Dragan, teaching assistant at Tufts University School of Dental Medicine.

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Pavel Scarlet, president of the International Association of Dental Students (IADS).

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Giving the FDI Oral Health Atlas to Sulaiman Saleh Al Reshaid, president of congress board of directors.

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In the desert with the dental students.

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Sunset in the desert.

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Having tea in a tent in the desert.

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After a meeting about the Saudi Arabi oral health strategy. With Hassan S. Halawany (left) and Solaiman M. Al-Hadlaq (right), both experts in health management and policy, from the King Saud University, Riyadh.

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Night in the desert.

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Thank you Buraidah!


Dhaka, Bangladesh – Dental Experts Conference 2012

November 30, 2012

I had the pleasure to visit for the first time Bangladesh, last November. I took the opportunity to meet with the Bangladesh Dental Society. I got a better picture of oral health in this 9th most populous country of the world…

Group photo with some of the around 400 dental medicine students I had the opportunity to address on behalf of the FDI, at the Dental Experts Conference, organized by Unilever Asia.Group photo with some of the around 400 dental medicine students I had the chance to address on behalf of the FDI, at the Dental Experts Conference, organized by Unilever Asia.

TV interview focusing on the FDI as a century old organization, the "Life. Learn. Laugh" Program. The partners in Bangladesh are the Bangladesh Dental Society and Pepsodent.TV interview focusing on the FDI as a century old organization and the “Life. Learn. Laugh” Program. The partners in Bangladesh are the Bangladesh Dental Society and Pepsodent. The interviewer was Vaidehi Ketkar, from Unilever Asia.

One of the speakers, Fred Schafer, CFC Clinical Unilever.One of the speakers, Fred Schafer, CFC Clinical Unilever.

450px-webimg-20121124-fdi-bangladesh-010Picture from the hotel.

My special thanks to Ju-un Choudhury, Ishtiaque and all the Unilever team in Bangladesh.


6th Moscow International Dental Exhibition MosExpoDental

November 18, 2012

By mutual invitation of the CEO of the 6th Moscow International Dental Exhibition MosExpoDental, Lina Vartanyan, and the president of Russian Dental Association, Vladimir Sadovski, I have been in Moscow last November.

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Opening of the exhibition.

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Group photo at the opening. On my right, the CEO Lina Vartanyan, and on my left, Prof. Sadovski, president of Russian Dental Association.

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Meeting of the FDI-ERO Working Group Integration, which I had the honor to open. Participants focused in particular on the Europe-wide standardization of several aspects of the profession as well as local approaches to pan-European issues, such as recognition of diplomas – with a view to increasing the professional mobility of dentists – oral health policy and academic training.

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The chair of the working group (WG) and FDI National Liaison Officer, Elena Ivanova, from Russia, with the chief dental officer of the Ministry of Health Care of Russian Federation and rector of the Moscow State Univesity of Medicine and Dentistry, Prof. Oleg Yanushevich, on her right, and Vladimer Margvelashvili, from Georgia, member of the WG and chair of the FDI Communication Committe, on her left.

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In the frames of the meeting, took place an exchange of view from presidents from Eastern European countries. Most of them, Russian speaking language, such as Kazakhstan, Kyrgystan, Uzbekistan, Tajikistan, Turkmenistan, and also Ukrania, Armenia and Georgia.

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I had the opportunity, as lecturer invited to the ongoing parallel congress “Innovations in Dentistry”, to deliver a presentation about FDI Vision 2020 – challenges of National Dental Associations.

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Group photo of all the participants, at the end.