James Lozier, the son and grandson of paper salesmen, set out to be a dentist. But carpal tunnel syndrome sent his career down a new road, and now he is in the position of buying paper, by the truckload. His unusual business: Publishing flashcards for future dentists, dental hygienists, and lawyers who are studying for their board exams.

To accommodate the stacks and stacks of paper that he keeps in stock, Lozier recently expanded from 1,500 square feet to 2,000 feet on Quakerbridge Road; he is putting his flashcards online, has redesigned his website, and bought a color printer.

Lozier says he misses his seven years of designing bridges and filling cavities. But when it comes to turning the lemons of a physical injury into lemonade, Lozier must rank near the top of the success list. With four full-time employees, including himself, his revenues have been about $1.5 million annually. His remarkable business is rooted in study habits that he established in childhood and an unshakeable confidence in his own vision.

A leading test preparation agency offered to buy him out 10 years ago and remains a formidable competitor. Yet Lozier, 46, has no intention of selling the business: “I love what I do,” he says. He works an eight-hour business day, except when he is doing research for new cards or printing cards, and then he works on the weekends. In slow times he and one of his longtime employees go over to Jasna Polana, mid-day, and play golf. A die-hard Giants fan, he buys season tickets to the Eagles in order to see the Giants play and uses the rest for business entertaining.

Making flashcards had always been Lozier’s key to good grades. Growing up in Hamilton, he used flash cards to learn the multiplication table, and in high school he made cards for his vocabulary words. “In dental school I would condense 100 pages of notes into 10 pages and study just that 10 pages. My buddies would say, ‘Do you have the sheets?’ and I would give them to my good friends. That kind of ‘meat and potatoes’ information is what’s on the back of the cards.”

The family mantra: Anything worthwhile is not easy. “I was the youngest of three boys, and we were raised to not be bored. We had chores, I was a paper boy, and I cut all our neighbor’s lawns.” He played high school baseball and football and was a defensive back at Trenton State (College of New Jersey) His father died shortly after he graduated in 1984, but he followed his brother to dental school at Georgetown, and his carefully crafted set of flash cards got him through the grueling dental board exams.

When he couldn’t work as a dentist any more, he turned to those flash cards. “I had developed my study product when I first got out of school so I had that to fall back on,” he says.

In 1992 his first employees were Susan Molnar, who had been his receptionist, and his mother, who was retired from McGraw Hill (she died two years ago). Through a mutual friend he met Steve Blandi, who had just lost his job on Wall Street. Steve’s son came aboard when extra hands were needed for the print shop. Sometimes his teenaged son and daughter, Jimmie and Ashley, help by making and packing boxes.

Lozier pitches in on production but spends most of his time doing card research and traveling to schools and trade shows. “I research my cards practically every day. Like I tell the students, it is not only doing updates, but getting better — making a better question, making the back of the card better. I am not re-teaching the material. I am narrowing it down from what they need to know to pass the exam.”

Among his expenses are $50 to $500 per illustration for a medical artist to provide black and white images. Alternatively he can pay copyright fees to textbook publishers. “One dental school publisher gives me the illustrations for free, because they say I am doing a good thing for the school.”

If students call with questions, he helps them out. “My customers are spoiled by me, because I am here, and I stand behind the product. A couple students have latched on to me like I am their personal tutor. That gets old. But over the years I have had a good reputation. There is a difference between real world dentistry and the national boards, but if they know the cards, they will pass.”

His share of the market for the 10,000 sophomore and senior dental students in the United States runs at about 90 percent. Most schools sell his cards at their bookstores and some schools (Indiana, West Virginia, and Tufts) require them. Indiana’s dental school buys the cards for their students and the Minnesota Dental Association purchases the cards for students from the University of Minnesota.

Dental students need two sets of the cards, one to take a four hour test when they are sophomores, and one to take another test when they are seniors. Dental cards cost $99 in 1992 but, for eight years, have been priced at $220 (for the 1,150 card set) and $250 (for the 1,400 card set).

“For group orders I bring the price way down,” says Lozier. In some cases Lozier competes against himself, because students sell last year’s sets online.

Dental hygienists pay $130 for 1,580 cards, but members of a national trade group get a $15 discount. (Lozier says he prices the hygienists’ product comparatively low because the hygienists are spending much less for their education and will make lower salaries, but lots of other products are available for this market..)

Cards for would-be lawyers meet very stiff competition. Most law school graduates want to take bar-exam prep courses, for which the cards are only a supplement, not the slam-dunk solution that the dental cards are. Law cards cost $160 for 800 cards. “We have gotten great feedback on the product, but getting the word out there is difficult,” says Lozier.

A flashcard order starts with a shipment of paper, stacked six feet high, covering a 10-foot square area of the floor. An industrial strength machine, a Polar Cutter, slices through 500-sheet stacks of 11 x 17 sheets, twice as thick as regular paper. Each sheet makes eight flashcards. “We program in the cuts,” says Lozier, “and after the first cut it automatically moves to the next position. A week’s worth of printing could take a couple of days to cut.”

In the beginning Lozier sent printing jobs to an offset print shop. “The costs were crazy.” So he bought his own digital printers. Because they were good only for black and white, he began to use colored paper, a 70 or 80-pound cover text, with the different colors representing different subject matter areas. Now he has a top of the line set-up, including a humdinger of a printer, a $350,000 Heidelberg Digimaster.

From his workstation, he sends the print order to the Heidelberg, which prints and collates the cards. It takes all day to print 100 sets of the cards, so for a big order the printer runs all weekend. Most of the time, though, he prints cards in sets of 24 sets. That way everyone can start shrink wrapping and packaging the sets.

He has just bought a $70,000 color printer, a Canon C-1 Image Press, to supplement the black and white so that he can use color in some of the Internet cards. He also bought a Duplo machine for making booklets and giveaway pads for conventions.

He has also installed a camera in the shop so he can watch the cards print from his house. In addition he aims to leverage his Lamborghini of a printer to take short-run outside jobs, and has already gotten some business from restaurants that need menus printed.

But cards are just cards, yesterday’s technology. Today’s high school students are studying for the SATs on their iPods. Lozier’s cards are going to face stiff competition from the exam preparation companies, like Kaplan, the $1.6 billion firm owned by the Washington Post that bought Carnegie Center-based EduNeering last February. Kaplan has made an early entry into the dental market by offering courses to improve scores on the Dental Aptitude Test (DAT). At a Kaplan center in New Brunswick’s Kilmer Square, for instance, dental students can take a free practice exam and sign up for courses and products.

So Lozier’s four-person shop needs to upgrade. He has revamped his website to make it look more professional at a cost of about $8,000.

He picked Carnegie Center-based Genex Consulting to morph the first of his card sets, the ones on dental hygiene, up to the Internet at a cost of about $10 per card. Cards for student dentists will be on the Internet by the end of the year.

Dental hygiene students will be able to select from 14 sub categories and bring up the flashcards of that section. They can start studying or take a 100-question test based on the flash cards If they get a question wrong, the correct answer will link to the flash card. The colors of the site exactly match the colors on the card. “From my experience of doing this for 15 or 16 years, I have a certain esthetic, and I know it works,” says Lozier.

He is excited about the possibilities that the Internet version will offer. “People can do it on the go. Possibly, later, we can animate it and it will become very exciting. Students will have the ability to search more than 1,000 cards and bookmark where they left off. We will offer exams that simulate the exam. It will be phenomenal.”

His Internet price will be similar to the hard copy price, with a reduction if they are purchased together. Sets of dental hygiene cards, for instance, cost $130, including shipping and handling, and the market for them is 9,000 students annually in the United States and 6,000 in Canada. Lozier says he has only 20 percent of this market. “With the new edition, and instructors recommending it, it will grow.”

Dentistry is an art, he says, “but it is a tough profession. Nobody wants to see you, you are on a very tight time schedule, and what you do is very tedious. When I was dealt carpal tunnel, my hand would go numb with the drill. I miss doing dentistry, but I can’t complain with what I am doing now. I am making more money than as a dentist, that’s what my brother tells me, but what I do is not for everybody.”

Dental Decks Inc., 4065 Quakerbridge Road, Princeton Junction 08550; 609-919-9400; fax, 609-919-0902. James Lozier DDS. Home page: www.dentalhygienedecks.com.

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