An orthodontic practice shares one thing in common with manufacturing plants: Bottlenecks can slow everything down.

By Roger P. Levin, DDS

Years ago, one of the greatest manufacturing consultants identified that the single biggest factor in speeding up manufacturing was finding and eliminating bottlenecks. Bottlenecks are those things that slow down a system. Orthodontic practices are not vastly different than manufacturing plants in this regard.

Understanding bottlenecks in the orthodontic practice

The best orthodontic practices are the ones that have the best systems. Systems are step-by-step processes that are properly followed and lead to the highest levels of efficiency.

Most orthodontic practices have many bottlenecks within their systems with some being more impactful than others. Even if there is only one bottle neck that significantly slows down the treatment system, consult system, new patient experience system, or even case completion system, it will have a direct impact on the overall speed of that system. And one system can also slow down another.

Consider these examples of bottlenecks:

  • One orthodontic practice was unable to place new patients into the schedule for several weeks due to over-scheduling of chairs with everyday treatment. This led to a gradual decrease in overall practice production as new starts did not outpace case completions.
  • One practice had five assistants for five chairs, but one assistant was under-trained and much slower than the other assistants. Each time the orthodontist arrived at this assistant’s chair she had extra treatment that he had to perform and as such, lost minutes per hour.
  • Another practice could not keep up with answering their phones. Some calls went to voicemail and others did not leave messages.
  • Another office did not track or monitor overdue debonds. This led to a backlog of patients who were still coming in even though their cases were essentially completed. This filled chair time that could have been used for new patient starts or more productive treatment on patients who were still in process.

The list goes on. Some practices have multiple bottlenecks such as the above or others. But either way these slow down the system. We estimate that many orthodontic practices are 20% below potential simply due to bottlenecks and inefficiency.

The best place to begin to solve bottlenecks is one at a time. Take the time to review your systems, break them out step-by-step and identify any step that creates a bottleneck. Once you find a bottleneck, then the next step is to remove it by addressing the root cause of the problem. If an assistant is slower than all the others, that person needs additional training. If overdue debonds are clogging up your schedule, create a process that specifically contacts overdue patients for personalized scheduling. And so on. 

Bottlenecks slow orthodontic practices down. The slower the practice the lower the production and the longer the orthodontist will take to reach financial independence. OP

Roger Levin

Roger P. Levin, DDS, is the CEO and Founder of Levin Group, a leading practice management consulting firm that has worked with over 30,000 practices to increase production. A recognized expert on orthodontic practice management and marketing, he has written 67 books and over 4,000 articles and regularly presents seminars in the United States and around the world. To contact Levin or to join the 40,000 dental professionals who receive his Orthodontic Practice Production Tip of the Day, visit or email [email protected]