Rising Tide blog

By Dr. Cedric Lewis, DMD, Founding Partner and Clinical Director, Rising Tide Dental Partners

I’ve been named Honolulu’s Best Dentist every year from 2003 to 2026. I wrote a book called Failing to the Top — and the subtitle, “The Good, The Bad, and The Ugly of Building a Dental Practice,” is not marketing. I co-host the Dental Sherpas podcast, where I try to give young dentists the honest version of what ownership looks like. And in early 2025, I became a Founding Partner and Clinical Director of Rising Tide Dental Partners. People ask me why, at this point in my career, I would align with anyone.

The practice I built

I built my practice in Honolulu over more than two decades. I’m proud of what it became clinically, financially, and in terms of the reputation we earned in the community. But pride and honesty aren’t the same thing. And the honest version of my story includes a lot of mistakes.

The hardest part was never the clinical work. It was the loneliness of the early years. I came home to Hawaii in 1998 convinced I was going to be the next great cosmetic dentist in downtown Honolulu. I joined a boutique practice that didn’t believe in marketing, didn’t believe in weekends, and didn’t participate with insurance. Three years of networking, continuing education, and passing out business cards later, my 2001 tax return showed about $21,000 in income. I was twenty-eight, living back in my parents’ house, driving a car that occasionally needed to be jumped. I still remember sitting in my father’s office telling him I wasn’t sure I could make it in this profession. He looked at me and said, “Maybe you shouldn’t be a dentist. Have you ever considered law school?” That was his way — wry, and constitutionally unwilling to let me feel sorry for myself. It got me off the mat.

The mistake that shaped everything actually came earlier than the practice did. Fresh out of a continuing education course on full-mouth reconstruction, I sat a recently widowed woman down in a consult room and walked her through occlusion, anterior guidance, and a treatment plan that totaled about $42,000. She looked at me and said, “I don’t understand any of this. Can I think about it?” I never saw her again. I told myself she wasn’t the right kind of patient. Then the next patient did the same thing, and the one after that. I was right clinically every single time, and it did not matter at all — because the patient couldn’t understand what I was saying and had no reason to trust me. That failure, repeated over years and corrected one consult at a time, eventually became the framework I still teach today: Empathy, Simplicity, Urgency. Nobody handed me that. I earned it the hard way.

The biggest mistake of all was a leadership one. By 2014 we had opened a second location, and I got intoxicated by growth. I took my eye off my flagship practice and off my best people — hygienists, associates, managers who had been with me for years — and one by one they quietly walked out the door. It wasn’t their fault. It was mine. I had become a transactional manager when what my team needed was a servant leader. I spent 2017 and 2018 back in the chair rebuilding, working seventy-hour weeks after two back surgeries, relearning my own company from the associate’s seat. That serving of humble pie is the reason I lead the way I lead now, and it is the reason I care as much as I do about how doctors are developed and treated inside an organization.

I titled my book Failing to the Top because that’s what actually happened. I made every mistake. Hired the wrong people. Scaled too fast. Scaled too slow. Trusted the wrong partners. Trusted the right ones too late. The reason I wrote the book and started the podcast wasn’t because I have all the answers. It’s because I have the scars.

What I wasn’t looking for

When the Rising Tide conversation started, I wasn’t looking for an exit. I wasn’t shopping for a buyer, and I wasn’t in financial trouble. What I was looking for was harder to find than any of those things: a genuine community of operators who were at my level and still growing.

I’d tried the alternatives. I sat through programs from the major coaching companies. I took the continuing education courses that sell you twenty-step case-presentation scripts and communication-training packages at five thousand dollars a doctor. Some of it was genuinely good. But it all shared the same flaw — it was built for a generic doctor at a generic stage, and most of it was too complicated to survive a real conversation with a real patient at 6:30 on a Friday. Eventually I stopped looking and started building my own rooms. I founded the Mastermind Dental Forum, and later the Next Level Academy, because I could not find a table of operators who were actually at my scale and still hungry to grow.

What was missing was a group of dentists who had real skin in the game, who were operating at a similar scale, and who were willing to share what was actually working — not just what looked good on a slide deck.

The questions I asked before saying yes

I didn’t say yes quickly. I had a checklist, and the items on it weren’t the ones most organizations are prepared to answer.

The first question was about leadership. Not “is there a dentist on the board?” Almost every dental organization has that. I wanted to know: who has the final word when a strategic decision is on the line? At Rising Tide, the answer was dentist-majority voting control.

The second question was about clinical autonomy. Not “will I keep my clinical freedom?” I wanted to know: what happens when a corporate decision conflicts with a clinical one? Who wins? At Rising Tide, the answer is the doctor. Not as a courtesy. As a structural default.

The third question was about the people. I wanted to know who else was at the table. Were these dentists I’d learn from? Were they operators who’d challenge me? Were they people I’d want to call at 9 PM with a problem?

There was a fourth question, and it was the one that mattered most to me: at scale, does the platform amplify what makes each practice great, or does it dilute it? I had spent two decades building a model I believed in, and my real fear about any partnership was that joining something larger would sand down the very things that made us who we are. The Rising Tide answer was that we partner and elevate — we don’t acquire and consolidate. Partners keep their team, keep their brand, and keep operational autonomy over the things that matter to their patients.

If I’m honest, the moment I actually said yes had less to do with any single answer and more to do with a realization. I wasn’t looking for an exit, and I didn’t need the income or the title. What I came to understand was that keeping everything I’d learned locked inside the four walls of my own organization was no longer the right thing to do. A rising tide lifts all ships. If the model could help other doctors and other teams, I had an obligation to put it to work somewhere bigger than myself. That’s when I knew.

The answers were strong enough that I didn’t just join as a partner — I also took on the role of Clinical Director, helping lead clinical strategy, partner development, and long-term growth across the organization.

What surprised me

I’ve been in dentistry for over two decades. I’ve spoken at conferences, hosted a podcast, written a book. I’m not short on professional connections. But the depth of the relationships inside Rising Tide surprised me.

The willingness of operators to share their real numbers, their real problems, and their real playbooks was different from anything I’d experienced in a professional setting. This isn’t a mastermind where a facilitator leads you through exercises. It’s a working partnership where everybody at the table has actual skin in the game.

The thing that’s hardest to convey in a blog post is this: the value of a network isn’t in the concept. It’s in the 10 PM text to someone who has already solved the problem you’re facing. It’s in the quarterly conversation where someone benchmarks your numbers against theirs and tells you where you’re leaving money on the table. It’s in the trust that comes from everyone at the table having real equity and real governance roles in the organization.

What I’m contributing back

The Clinical Director role at Rising Tide isn’t ceremonial. I help lead clinical strategy for the organization by setting standards, mentoring new partner doctors, and making sure the “dentist-led” promise holds up at the practice level, not just on the org chart.

I bring my mentorship philosophy into the organization. For early-career dentists who join Rising Tide practices, I try to be the mentor I wish I’d had when I was starting out — someone who’s still practicing, still learning, and still willing to be honest about what he doesn’t know.

I don’t mentor young dentists because I have the answers. I do it because I have the scars. And scars are experience, which is worth more than any CE course I’ve ever taken.

My advice for practice owners evaluating partnership

When other practice owners ask me about my experience, my advice is consistent: dissect the story.

Every organization has a compelling narrative. The ones worth partnering with can back that narrative with documents — governance structures, equity terms, board composition, clinical authority protocols. If the organization resists showing you the structure, the story probably isn’t what it seems.

My second piece of advice: talk to the partners. The dentists who’ve been in the organization for six months, a year, two years. Ask them what they wish they’d known going in. Ask them if they’d do it again. Ask them how they feel about the organization today versus the day they signed.

At Rising Tide, we encourage that. We’ll introduce you to any founding partner you want to talk to.

Is this for your stage?

My story resonates most with mid-career and late-career owners — dentists who’ve built something significant and are asking: what’s the next chapter?

But the principles apply at every career stage. Early-career dentists can learn from operators like me who’ve already been through the hard parts. Mid-career owners feeling the weight of solo ownership can find peers who understand that specific pressure. Late-career owners thinking about legacy can see what a thoughtful transition looks like.

The common thread isn’t career stage. It’s the willingness to admit that running a great practice doesn’t have to mean running it alone or giving it up entirely. You don’t build a legacy alone. You build it with people who are climbing the same mountain.

If that sounds like where you are, reach out.