When Will the Competition Arrive?

A strategic look at when—and how—new competitors emerge in orthodontic markets, and why proactive marketing and referral protection determine whether practices grow or decline.

By Roger P. Levin, DDS

After working with thousands of orthodontic practices, we’ve repeatedly seen one costly mistake: relying on low level or stagnant marketing. When you’re the only orthodontic option in town, this may not seem to matter. But once competition enters the market, practices with weak marketing routinely experience production and doctor-income declines of 5% to 40%. No practice should ever face this avoidable setback.

What Does Competition Look Like Today?

Years ago, orthodontic competition mainly came from other orthodontists. Few general dentists placed brackets, and there were no alternative treatment outlets. However, that landscape has changed dramatically. Today’s orthodontists face competition from multiple directions:

• New orthodontic practices. At some point, every orthodontist will see new offices open nearby. New practices typically launch with aggressive marketing campaigns designed to attract patients—often pulling from established practices in the community.
• Existing competitors that “wake up.” We frequently see established competitors reinvigorate their marketing due to declining production, new motivation from a course or webinar, or concern about future trends. The reason doesn’t matter, but the impact does. These competitors are pulling patients from your practice.
• Former associates opening practices close by. Restrictive covenants can help, but they are not always effective depending on geography and state laws. Many associates eventually open practices nearby and inevitably take referrals with them.
• Aligner-driven competition from multiple provider types. Aligners have opened the door for more providers to enter the orthodontic space. While general dentists still send $3.6 billion in referrals annually to orthodontists, some also offer aligner treatment. It’s common in business for your biggest customer to also be a competitor—orthodontics is no different.
• Economic downturns. A slower economy functions like a competitor. Parents and patients delay or decline treatment, and in past recessions many practices lost large numbers of patients that were never regained.
• Orthodontic fee wars. At a recent conference, a young orthodontist asked me for advice on how to respond to a competitor offering treatment at $3,500—far below her $5,600 fee. This type of “fee war” is becoming more common. Practices must build clear value and branding strategies to demonstrate why their fees are worth $2,000 more than the competition.

When Will Competition Arrive?

You likely won’t know when it will arrive, but it will happen. The mistake is assuming strong referrals today guarantee strong referrals tomorrow. Referrals are the number one driver of orthodontic practice success and protecting them requires ongoing effort. Here are three actions you should take immediately:

1. Launch a comprehensive referral marketing program with at least 15 strategies. Your practice should continually engage parents, patients, referring doctors, and the community. Social media matters, but it can shift overnight—one practice we worked with saw a 40% drop when algorithms changed. A broad, multi-channel referral marketing program creates stability and long-term growth.
2. Build and communicate your value proposition. Every practice must clearly articulate its value. Different generations value different things—older generations prioritized service and reasonable payment plans; younger generations want flexible financial options, fast service, and text-based communication. But both want the same ultimate result: a beautiful smile. That should be the focal point of every treatment coordinator consultation.
3. Strengthen relationships with general dentists. Many orthodontists try everything except building strong referral relationships. Why? Because it takes work. But general dentists remain consistent regardless of economic cycles or competitive shifts. You must also continually add new referring doctors as others retire or sell their practices. Make the time and effort to strengthen these relationships before you desperately need them.

Competition is inevitable. You won’t always know when or from where it will appear, but the laws of business dictate that competition always expands. The most successful practices build comprehensive, multi-strategy referral marketing now, paired with strong value-based messaging and branding. These are the practices that rise to the top 25% and achieve outstanding doctor income and long-term financial security. OP

Photo: ID 162652761 | © Korn Vitthayanukarun | Dreamstime.com

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