The Dangers and Opportunities in Orthodontic Practice Today

Orthodontics is entering a new era due to two factors—one negative and one positive. Having a successful practice in the future is tied to understanding how to balance both.

By Roger P. Levin, DDS

For many years in dental history, orthodontic practices were stable. The economic laws of supply and demand worked in the orthodontic practice’s favor, and most orthodontists were sufficiently busy to have an excellent lifestyle and fun retirement. Furthermore, this could also be accomplished working 3 or 4 days a week due to the volume factor in orthodontics that does not exist in other dental specialties, or general practice. As a result, most orthodontists were able to build extraordinarily successful practices and maintain that success throughout their careers.

Fast forward to today. orthodontics is entering a new era due to two specific factors. One factor represents the danger, which is increased competition emerging with new service delivery models and different fee levels than in the past. The other factor represents opportunity, which is achieved through significantly increased chair time available in most orthodontic practices, allowing the practice to treat more patients and increase production proportionately.

The danger: competition

Orthodontics has had a long run with low levels of competition. Now, with the emergence of aligners, orthodontic competition is expanding and will continue to expand rapidly. In addition to the traditional orthodontic practice, we are now seeing general dental service organizations (DSOs) adding orthodontic treatment, orthodontic-only DSOs and general dentists providing aligners, as well as direct-to-consumer orthodontics. Along with these new service delivery models are variations in fees ranging from below $2,000 for full aligner treatment to orthodontic practice fees which average $5,700, with many practices charging far more. This level of competition is a danger for every orthodontic practice.

Each practice should have a specific section of strategic planning that focuses on the brand of the practice and referral marketing strategies that will create a continual stream of referrals. In today’s more competitive landscape, referral marketing will be more critical than ever before, and Levin Group suggests that orthodontists market in five focus areas: patients, parents, referring doctors, social media, and the community. We also always emphasize that you must not write off referring doctors simply because they participate in some orthodontic cases themselves. A recent survey indicated that $3.6 billion per year of revenue is referred to orthodontic practices by general practices. This may be lower than in the past, but it is still a huge amount of revenue that is being referred to orthodontic practices.

Referral marketing has always been part of the orthodontic specialty, but now we encourage orthodontists to think of referral marketing as mandatory. It should be viewed as just as important as providing clinical treatment in order to allow practices to remain successful. Not all orthodontic practices will automatically be successful in the future. We are entering an era where there will also be a fragmentation of practices ranging from phenomenally successful to highly challenged. You want to ensure that your practice is in the phenomenally successful group, which is typically represented by the top 50% of orthodontic practices in regard to production and profitability.

The opportunity: more chair time (without adding more chairs)

Although it is still emerging, remote monitoring is expanding in orthodontics. We are in the early adoption phase for remote monitoring but in looking at market forces and trends, it is on a trajectory to become increasingly mainstream. I am not commenting in any way clinically on its merits and do not want to enter that debate. However, it is evident that remote monitoring is going to expand, with many European orthodontic practices already using it at an extremely elevated level.

Assuming that this hypothesis is correct, orthodontic practices will be able to double, or even triple in some cases, the available chair time that is available to patients today, in the same number of hours per week. This leads to many choices, but the real opportunity will be for practices to mathematically identify how much additional chair time will be available and to work with the referral marketing program explained above to fill that time to create some of the largest production per orthodontist seen in orthodontic practices in history.

When a practice mathematically calculates the effect that remote monitoring can have, it will understand how much extra chair time is available, and what referral marketing activities are necessary, to help fill that time out. Practices must also keep track of how quickly they transition into remote monitoring and reevaluate the schedule on a continual basis. When practices go through changes, they can sometimes lag behind on the scheduling system, which often delays taking advantage of opportunities.

At first, those practices will not worry about revising the schedule, but as remote monitoring grows as we are predicting, the opportunity to have enormous gains in patient volume and production will exist.

Some of the largest and most successful orthodontic practices in history will emerge because they understand both these dangers and opportunities and are preparing to overcome competition and take advantage of increased patient volume. This is essential information for practices in order to create the right dynamic shifts to create high levels of success and maintain those levels going forward. OP