When Dr. Brandon Owen bought a practice in Fort Collins, Colorado in 2006, he wasn’t looking to bring orthodontics to an under-serviced area. He readily admits that the area probably had a full contingent of orthodontists. But the allure of the Fort Collins area itself was simply too overwhelming for him and his wife to consider going anywhere else. What he needed was a way to differentiate himself, and his practice.
Towards the end of his first year, he found himself growing frustrated with the results he was getting from his Invisalign cases. He estimates that up to 40% of his cases weren’t finishing out in a way that met his own standards. It was about this time when a DENTSPLY GAC representative came in and showed him the In- Ovation L® bracket system. While he hadn’t previously considered lingual a direction he’d like to pursue, he did see it as an esthetic treatment solution that would give him much more control than Invisalign. So Dr. Owen decided to give lingual treatment a shot.
“The first year I offered lingual, I think we did only six cases,” says Dr. Owen. “That number rose to about 20 the next year. It’s been going up steadily since then.”
What he didn’t recognize during that first meeting with his GAC representative, was that offering In-Ovation L® and lingual treatment would give him an ideal way to approach local GP’s in a non-confrontational way.
“It was a great opportunity for me to go into a dental office and say, ‘Hey, I know you’ve got a relationship already, but on the outside chance you’ve got someone who might be interested in lingual, I’m your man.’ We got a few referrals that first year. But the cases we did do… the results were outstanding, and patient satisfaction was through the roof! Once the practices started hearing what a positive experience their patients had with us, they started referring a bigger percentage of their cases. Eventually it just reached a tipping point.”
For a practice that’s less than a decade old, in an area that’s already got a number of well-established practices, Dr. Owen’s practice is growing at a pretty remarkable rate. He credits most of it to lingual.
“We’ve had a 30% growth rate each year, for each of the past four years.”
“We’ve had a 30% growth rate each year, for each of the past four years. Lingual patients are driving new growth in my practice. It’s far and away my most profitable treatment. About one third of my new case starts included lingual braces in some form. That includes full lingual, partial lingual and the hybrid where I perform lingual on the top arch and labial on the bottom.”
Dr. Owen says there are a couple of misconceptions regarding lingual cases. The first is that they are difficult to work with. Like all learned skills, he says it’s all in how you approach the learning curve.
“I tell everyone to learn on the top teeth. It’s a great way to make the transition. Execute the strategy of starting small. Don’t take the hardest cases first. Then just grow into it. Last year we started 35 full lingual cases, and nearly 100 limited lingual cases, which is a really large number. It puts us in the top 100 practices in the United States by some measures.”
“I’m using In-Ovation L® and it really is just about as easy as doing labial. Wire changes are pretty straight forward since the brackets are self-ligating. Plus we’re typically just doing limited lingual, the front six or eight teeth.”
This brings up another misconception when dealing with lingual cases. His office does indirect bonding, which he claims allows him to match, if not exceed, the speed and accuracy of traditional labial bracket placement.
“Because we’re placing the lingual braces on the model first, I have a direct line of sight. I can actually get closer than I can doing standard labial treatment, which allows me to be very precise in where I want the brackets. Yes, this does take a little bit longer. But then, my bonding appointments average under two minutes of ‘doctor time’ per patient. I look at each tooth for a couple of seconds to make sure everything is in place and then turn the case over to my team.”
Dr. Owen says that lingual is a great way to lower the barrier of entry, particularly for older patients. “For adults, it’s usually not about the cost. It’s the esthetics and the stigma of getting braces. Once you remove that barrier, allowing people to get treated without others seeing they’re getting treated, you’ve opened up a whole new pool of potential patients.”
Not to mention the satisfaction that comes with changing someone’s mind. “
There really is a level of fun involved. To see someone transform from a reluctant patient when they walk in the door, to someone who’s eager to get started, it’s incredibly satisfying. It’s just fun.”
While his practice is still the only lingual service in Fort Collins, he expects that to change over the next fiveyears. He says the profitability is just too significant to ignore. Dr. Owen says in his practice, limited lingual cases generate nearly double the profit of fixed labial cases because they take half the time.
“Patients pay the same for limited lingual that they do for full labial. The profit for the practice is almostdouble. The thing is that people are happy to pay it. It’s still less than Invisalign since there’s no lab bill.”
“If you look at what you’re charging as a standard rate, your per-visit profit is going to go through theroof with lingual treatment. Of course the numbers will vary for every practice. But it’s not unreasonable to expect something like an extra $280 to $400 per visit. If you’re seeing 30 patients a day, you can be talking about an extra $6,000 per day. Plus, it’s a good way to offset the impact of Invisalign.”
In the end, Dr. Owen says that lingual has given his practice a true competitive advantage.
“If you can do something that nobody else in the marketplace is doing, and do it better than anyone else, you’re going to own it. There are 17 orthodontists in Fort Collins. I’m the only one doing lingual and I’m just about doubling my practice every three years. Case satisfaction is through the roof. Lingual treatment is far and away my patients’ favorite. ”
Introducing No • Trace™ Plus from DENTSPLY GAC New Digital Lingual Service Offers Access to a New Patient Base
Many adult patients with the means and desire to straighten their teeth are still waiting for a truly esthetic treatment option. Now with the new No•Trace Plus digital lingual system, we will be offering orthodontists in the United States the ability to treat a wider spectrum of patients with lingual braces.
No•Trace Plus uses the latest in 3D technology to make lingual treatment fast, efficient and profitable. It allows practices to initiate a new revenue stream while offering a significant point of differentiation from the competition. Utilizing the In-Ovation L bracket, No•Trace Plus unites the efficiency of self-ligation with one the most trusted names in orthodontics.
Proven in Practice
No•Trace Plus is based on the successful eClips platform that’s been used in Europe to finish over 2,000 cases. This intuitive digital platform allows the practice to maintain complete control of the case while embracing the latest in digital efficiency.
Lingual Made Simple!
With No•Trace Plus cases, impressions are taken and then sent to the No•Trace Plus lab, along with the individual orthodontic prescription. The case is then digitized, and the teeth are moved into their ideal position based on the orthodontic prescription and prescribed treatment philosophy. The doctor is then able to digitally review and approve the case, making sure it meets their standards. Once approved, the No•Trace Plus lab will create an indirect bonding tray that a technician in the practice can use to mount the brackets.
A Plus to Your Practice
• Additional revenue stream
• Fast and easy indirect bonding
• Rapid wire engagement with self-ligating brackets
• Virtually eliminates patient compliance issues
• You control the treatment
View Dr. Owen’s tips on lingual techniques on DENTSPLY GAC YouTube Channel.
This article first published in 2014 OrthoWorld