Orthodontic Patient Experience: A Practice Advisor’s Playbook for 2026

Episode: How to Create Raving Fans for Your Orthodontic Practice Show: GrowOrtho

Host: Zach Dykes

Guest: Melissa Gardner, Practice Advisor at HIP Creative (20+ years in orthodontics and dentistry)

Published: [YYYY-MM-DD] · Last updated: [YYYY-MM-DD]

Summary: The biggest growth lever in an orthodontic practice is the patient experience, not the technology or the clinical work, because patients talk about their best and worst visits and almost never the ones in the middle. Melissa Gardner breaks the patient journey into four stages that each need deliberate attention: the first impression at the door, the treatment coordinator consult, the routine mid-treatment visits, and retention after debond. The tools are inexpensive and specific: a clean and clearly marked entrance, a greeter who is off the phone, personalized chart notes that track a patient’s life and not just their wire, a treatment coordinator handoff done out loud in front of the patient, and a debond celebration with a gift, a photo, and the candy the patient could not eat during treatment. Practices that do this generate their highest-quality referrals through word of mouth and social proof, and they keep former patients coming back for retreatment instead of shopping elsewhere.

Topics covered: patient-centric care, first impressions and office environment, the treatment coordinator consult, mid-treatment engagement, chart notes and documentation, balancing efficiency with empathy, team accountability, retention strategy, debond celebrations, referrals and word of mouth.

Key entities: HIP Creative, GrowOrtho Podcast, GrowDental Podcast, treatment coordinator (TC), archwire sequencing (.016, .018, .014 x .025), retainers, debond, Amarillo, Texas.

About the author

By Luke Infinger — CEO & Co-Founder, HIP Creative | Author

Luke Infinger has spent more than 12 years helping dental and orthodontic practices grow through marketing, software, and education. He is the founder of HIP Creative, which works with more than 500 dental and specialty practices across the country, and the creator of Practice Beacon, a lead-tracking CRM built specifically for dental and orthodontic teams. His work has included taking practices from regional obscurity to nationally recognized growth benchmarks, among them helping an orthodontist become the fastest-growing in the country by 2018. He is also the author of multiple books on practice growth and a sought-after speaker for dental continuing education events. LinkedIn: https://www.linkedin.com/in/luke-infinger-b36a001b/

Most orthodontists compete on the wrong thing. They invest in the newest scanner, the fastest bracket system, and a marketing budget, then wonder why growth stalls while the practice across town with older equipment keeps filling its schedule. The orthodontic patient experience is the variable that actually separates a practice that thrives from one that merely gets by, and it is built from small, repeatable interactions rather than capital purchases.

Melissa Gardner has spent more than two decades in orthodontics, working chairside as an assistant, running clinical operations, sitting in the treatment coordinator chair, and covering the front desk. On this GrowOrtho episode she made a blunt case: patients decide whether to rave about you or warn people about you, and they make that decision based on how you made them feel, not on how straight their teeth came out.

This post breaks down her framework for the full patient journey, from the moment a prospective patient searches for your building to the day they walk out with their braces off, and why each stage is a referral opportunity most practices waste.

Key takeaways

• Patients talk about their best experience or their worst, rarely the middle, so a practice that is merely competent generates no word of mouth in either direction.
• The first impression is decided before the front desk: a clean, bright, clearly signed entrance and a greeter who is off the phone determine whether anything you do afterward matters.
• Chart notes should track a patient’s life, not just their wire. A note about a football game, a prom, or a favorite color lets any team member re-engage a patient who may not see the same assistant twice.
• A treatment coordinator handoff done out loud, in front of the patient, builds trust and saves the doctor from re-asking questions the patient already answered.
• Efficiency and empathy are not in tension. A documented, standardized wire sequence frees up the minutes while a patient waits on the doctor, and those minutes are when the relationship gets built.
• Retention is the most overlooked stage. Patients who leave the debond appointment feeling celebrated wear their retainers, refer others, and return to you (not a competitor) if they ever need retreatment.
• Debond celebrations (a gift, a photo, the candy a patient could not eat with braces) are low-cost and drive a practice’s highest-quality referrals through social proof.

 

Why does patient-centric care matter more than the clinical work in orthodontics?

Patient-centric care matters because the practice is a people business before it is a clinical one, and losing sight of that undermines the entire model. Melissa’s framing is that orthodontics changes a patient’s life well beyond the teeth. A patient carries their smile from graduation to a wedding to their first family photos, and the confidence that comes with it shapes decisions for years. The clinical work is the mechanism, but the outcome the practice is really selling is confidence.

The practical risk is getting buried in the operational noise. A practice owner spends the day closing cases, chasing same-day starts, and reacting to no-shows, and it becomes easy to treat each patient as a task rather than a person. Melissa’s point is that the practices seeing the most growth are the ones that treat every touchpoint, the lighting, the greeting, whether a team member remembers a detail about the patient, as part of the product. When a practice loses sight of the people using its technology and systems, it loses sight of the business itself.

What makes an orthodontic practice stand out in a competitive market?

An orthodontic practice stands out when the experience is memorable enough that patients actively talk about it, because people share their best experiences and their worst but stay silent about everything in between. A practice that plateaus and gets by does not necessarily fail, but it does not generate the word of mouth that fuels growth. In a market where competitors offer the same clinical result, the experience is what people rave about, review, and recommend.

Melissa is direct about the honest math of an orthodontic visit. A patient usually leaves sore from a wire change or numb from an injection, so the clinical portion is not what will make them feel good. If they walk out feeling great anyway, it is because of the interactions they had. That is the part a practice controls completely, and it is what turns an ordinary patient into an advocate. You can have strong marketing, a good team, and current technology, and still lose if the patient does not leave feeling good.

What are the “little things” that improve the orthodontic patient experience, and why do they matter?

The little things are the small, low-cost, repeatable gestures that signal a patient is known and valued, and they matter because they are what a patient remembers six weeks later. They start on the very first phone call, with a greeter who asks about the patient’s day and makes politeness the norm rather than rushing to book.

From there, Melissa listed specific, inexpensive touches she has seen work in real practices:

• A coffee bar and a tooth-brushing station that make the space feel welcoming.
• A signature scent chosen deliberately to make patients more comfortable, something one practice had researched for its psychological effect.
• A welcome board at the entrance listing new patients by name and congratulating patients getting their braces off, so a patient feels prioritized the moment they walk in.
• Chart notes about a patient’s life (an upcoming football game, a prom, a family event) that any team member can reference, because the patient will not always see the same assistant.
• Remembering small preferences, such as the color a patient always chooses, and asking “are we going with teal again?”

Her analogy for why this compounds: think of the small thing someone once did for you, like a cashier waving off five cents so you did not have to break a dollar. It cost almost nothing and it made you smile. In a practice, those touches can turn a patient’s bad day around by reminding them of something good, and that emotional imprint is what they carry and repeat.

How does human connection set a dental or orthodontic practice apart in an age of AI and self-checkout?

Human connection stands out precisely because so much daily life has been automated, and patients notice the contrast. Melissa and Zach both landed on the same observation independently: between self-checkout lanes, AI phone menus that make you press a number a dozen times to reach a person, and ordering everything online, people are surrounded by convenience and starved of interaction.

Convenience has its place, and Melissa is a fan of it for a five-item grocery run. But the practices winning on experience are the ones offering the human piece that automation removed: a real person answering the phone who can handle an objection or a concern in the moment, a genuine “how are you today,” a team member who remembers a detail. As more of the economy automates, that human interaction becomes a bigger differentiator, not a smaller one, and it is something an orthodontic practice can offer that most of a patient’s day cannot.

What first impression should an orthodontic practice create when a patient walks in?

The first impression should be a clean, bright, welcoming environment paired with a greeter who is fully present, because those two things decide whether anything you do afterward will register. Because orthodontics is healthcare, the space has to feel clean enough that a patient is comfortable opening their mouth, without feeling cold and clinical. A dark, dingy, or uninviting entrance sets a tone the rest of the visit cannot recover from.

The second half is the greeting. Melissa contrasted a spotless urgent care with no one to welcome patients (just a sign-in sheet) against a practice where a smiling person acknowledges you and makes you feel expected. The disconnected greeting, where a staff member is on the phone and half-waves you in while you stand unsure of what to do, is one of the fastest ways to lose a first-time patient. She favors keeping phones in a back area so the person at the front can actually greet.

Zach added the piece that comes before the door: wayfinding. A first-time patient is on high alert, wondering if they are even in the right place. Clear exterior signage that says “enter here” lowers that anxiety, especially when a patient’s GPS drops them at the wrong spot. The old barrier of a sliding glass window over dark wood signals “you shall not pass,” while an open, warm entrance with something as simple as offered water signals that the patient belongs there.

How should a treatment coordinator turn a consult into a standard that sticks?

A treatment coordinator (TC) sets the standard for the entire treatment relationship in that first consult, so the room needs both a smooth process and a person who actively engages. When the process feels discombobulated (a patient shuffled between rooms, left sitting alone, no one acknowledging them) it erodes trust before treatment even starts. A streamlined process behind the scenes signals competence: the team knows what they are doing, they brought the patient back quickly, this is a place worth staying.

The second half is engagement. A patient in the TC room may be nervous, scared, or excited, and leaving them alone lets their mind fill the silence with worry. Melissa’s rule is to never leave a patient alone and unacknowledged. Find a reason for them to be excited, whether that is the colors, the outcome, or just conversation about school or their day, and use it to break down the wall everyone brings into a first appointment. She frames the patient as the star of the show and the practice as the guide helping them along the journey.

The TC handoff to the doctor should happen out loud, in front of the patient. Rather than disappearing behind a door, the TC introduces the patient directly: this patient is excited about braces, a little nervous because they play football, and hoping to be done by senior year. Done in the open, the handoff proves the team listened, puts the patient at ease, and lets the doctor start exactly where they need to instead of re-asking questions the patient already answered on the phone and in the consult.

How do you keep routine mid-treatment visits from feeling like an assembly line?

You keep routine visits engaging by treating documentation as a relationship tool, so every appointment references the patient’s life and not just their wire. Mid-treatment visits are inherently repetitive: change a wire, note the rubber bands were not worn, move on. Left on autopilot, they make a patient feel like a number, which is the opposite of what earns a referral.

Melissa’s fix is a specific notation habit. In a different color or in italics, log what was discussed at the last visit about the patient’s life, not only the clinical steps. At the next appointment, any team member can reopen that conversation, ask about the football game or the event, and make the patient feel as special as the day they started. For younger patients, the color choice is the hook: lead with “what color are we doing today,” tie it to a favorite team or an upcoming game, and the mundane appointment becomes something they look forward to.

She stressed that these appointments matter more to patients than the team assumes. Kids count down to them, choose colors in advance, and even start wearing their rubber bands the week before because the appointment is coming. Unlike a shot or a blood draw, an orthodontic visit is a step toward a goal, and treating it that way keeps the energy up without lengthening the appointment.

How can an orthodontic team be efficient and empathetic at the same time?

Efficiency and empathy reinforce each other because good documentation is what creates the time to connect. Melissa described a standardized wire sequence her practice ran (moving through a .016, then a .018, then a .014 x .025, then a scan and repositioning), and knowing that sequence cold made the clinical work fast. Precise notes on what was done last time and what is planned this time remove the guesswork that slows an assistant down.

The payoff is time. An assistant almost always waits on the doctor, who is running multiple chairs and will not appear the moment a light goes on. Those waiting minutes are the opportunity. With the clinical steps already documented and understood, the assistant can spend that time talking to the patient, asking about a hard day at school or a test, and logging what they learn into the notes for next time. Empathy is not an add-on that costs efficiency. It runs on the time that efficiency creates.

How do you train a team out of autopilot and get consistent chart notes?

You train consistency through repetition, accountability, and teaching the reason behind the habit, because most people need to understand the why before the how sticks. Not everyone is a natural note-taker, and a practice cannot simply demand better notes and expect change.

Melissa’s approach is to make patient-centered documentation a standing part of the practice’s rhythm. Use the morning huddle to reinforce why notes matter, framing them as the lifeblood of the practice: they tell the team what was done, what rubber bands a patient wears, and what comes next, so the team never looks like it does not know the patient. Standardize the note format so every entry includes the date, what was done, the wire, and a personal or conversational note, which makes the personal note a non-negotiable field rather than an afterthought. When a note gets missed, address it rather than letting it slide, because the personalized detail is what lets the next team member re-engage the patient. Improvement compounds at roughly 1% better each visit until the habit becomes muscle memory and the standard of care.

Why is retention such a critical and overlooked stage in orthodontics?

Retention is critical because it is a long-term investment and an ongoing referral source, not the finish line most practices treat it as. It is easy to view the debond as mission accomplished, but the clinical reality is that patients often stop wearing retainers over time and a meaningful share end up back in treatment years later. How the practice handles the end of active treatment determines where those patients go next.

Melissa framed retention around two outcomes. First, a patient who leaves feeling celebrated is more likely to actually wear their retainers and protect the result, because they understand its value and want to keep the smile. Second, that patient becomes a referral engine and, crucially, comes back to you if they ever need retreatment. Patients have other options, so the goal is that the first practice they think of in a worst-case scenario is yours. She was emphatic that retreatment should never be handled with guilt or shame. A patient who fears disappointing the team will simply go somewhere else, while a patient treated like family will return.

What are simple ways to make the end of orthodontic treatment feel special?

You make the end special by building the celebration before, during, and after the debond, with specific low-cost gestures that mark the accomplishment. It starts at the appointment before the debond: the team makes a visible deal about the braces coming off next time, and acknowledges whether the patient finished early or needed extra months, so the excitement builds in advance.

On debond day, Melissa’s concrete tactics included:

• A welcome board or a front-desk team member who knows this patient is here for their debond and celebrates it as they arrive.
• The treatment coordinator making a point to come see the finished smile in person. Melissa, as a TC, tracked her patients’ debond dates and would run across the office to see the result, and patients loved that someone came specifically for them.
• A debond gift: whitening gel for the new retainers, a T-shirt, or a swag bag that celebrates the accomplishment.
• A photo moment, a picture with the doctor, a photo booth, or a branded accent wall.
• The candy or food a patient could not eat during treatment. Practices do this with candy machines stocked with Jolly Ranchers, gumballs, and Starburst, or a bin of mini candy bars, or even a popcorn machine. One effective move is to ask the day before the debond what treat the patient has missed most, then have it ready.

The point is that the patient spent a year or more with metal in their mouth, sore every six to eight weeks and avoiding favorite foods. A celebration that acknowledges that effort turns a clinical endpoint into an emotional high.

Do debond celebrations actually drive loyalty and referrals?

Yes, celebrations are one of the highest-quality referral sources a practice has, because they convert a finished patient into visible social proof. Melissa’s experience is that the impact is direct and consistent: the photo with the doctor gets posted, the patient reviews and raves about the experience, and other people see it.

She tied this to fear of missing out. When a former patient sees someone else taking a smiling selfie with their orthodontist and posting about how great the experience was, and their own practice sent them off with a flat “congratulations, wear your retainers,” they wish they had gone elsewhere and start recommending the practice that celebrated, even though they were never a patient there. A celebrated patient becomes an ongoing advocate. Her closing line captures the whole thesis: every orthodontist went to school and can straighten teeth, so the real competitive question is whether you can make a patient fall in love with having had braces.

What makes practices lose sight of the patient, and how do you stay focused?

Practices lose sight of the patient because the people delivering care are human, carrying stress, bad days, and difficult prior appointments into the next room. Seeing the same wire type on the fifth patient in a row breeds monotony, and a hard interaction can pull focus away from the person in the chair.

Melissa’s answer is to consciously step into the role. She genuinely cares about patients, and part of that care is setting her own state aside for the appointment: take a breath, reset, get a coffee, and remember that the patient may be going through something as hard or harder than whatever the team member is carrying. In that moment, it is the patient’s moment, and treating them the way you would want to be treated on your own bad day is the job. This is not about diminishing the team member’s own stress. It is about being present for the person who is paying for and relying on the experience the practice promised.

The anchor she comes back to for staying focused long term is simple: she has never seen teeth walk themselves through a door. The teeth are the focus of the clinical work, but they are meaningless without the person attached to them, and the purpose is a lasting smile that serves that person for life. Keep the people first and the teeth second, and both get taken care of.

FAQ

What is the single biggest factor in an orthodontic patient’s experience? How the patient feels when they walk in and when they leave. Patients usually leave a clinical appointment sore or numb, so the interactions (the greeting, being remembered, being celebrated) are what determine whether they feel good about the visit and talk about it afterward.

Why do chart notes matter beyond clinical tracking? Because patients rarely see the same assistant every visit, personalized notes about a patient’s life let any team member re-engage them and make them feel known. Melissa recommends logging a personal or conversational detail in a distinct color or italics at every appointment, alongside the clinical record.

How should a treatment coordinator hand a patient off to the doctor? Out loud and in front of the patient. The TC introduces the patient and their context (excitement, nerves, goals) directly, which proves the team listened, puts the patient at ease, and lets the doctor start without re-asking questions the patient already answered.

How do you make routine mid-treatment visits feel meaningful? Reference the patient’s life from your notes, lead with something they look forward to like color selection, and tie it to their world such as matching a favorite team. Small, consistent touch points re-engage a patient without lengthening the appointment.

Why is the debond appointment a referral opportunity? A celebrated debond gets shared. Patients post photos, leave reviews, and recommend the practice, and that social proof drives fear of missing out among people who then choose or recommend the practice. A flat debond generates none of that.

Should patients feel guilty about needing retreatment? No. Handling retreatment with guilt or shame pushes patients to a competitor. Treating former patients like family means they return to you if they ever need treatment again, which keeps retention as an ongoing referral and revenue source.

Glossary

Treatment coordinator (TC): The team member who guides a patient through the initial consultation, presents treatment, and often manages the patient relationship through the practice. In this episode, the role responsible for setting the tone for the entire treatment experience.

Debond: The appointment where fixed braces are removed at the end of active treatment.

Archwire sequence (.016, .018, .014 x .025): The progression of orthodontic wires used through treatment. Melissa references a standardized sequence as an example of the documented routine that lets a team stay efficient.

Retention: The phase after active treatment, focused on maintaining the corrected position of the teeth, typically with retainers.

Full episode transcript

Zach Dykes [00:00]: The real difference maker in orthodontics isn’t tech or even treatment. It’s the experience patients have with your practice. Welcome to the GrowOrtho live stream. I’m your host, Zach Dykes, joined by Melissa Gardner, HIP’s practice advisor. Melissa, welcome to the show.

Melissa Gardner: Thanks for having me back, Zach. I always enjoy an invitation.

Zach Dykes: You’re our second repeat guest. The only other person to come on twice is James, so you’re in the exclusive club now.

Melissa Gardner: A master’s jacket, maybe. The nice orange one.

Zach Dykes: Maybe I can sweet-talk somebody into that. In today’s stream we’re talking about what it means to stay truly patient-centric, from the first impression when someone walks through the door, to keeping care consistent through treatment, to finishing strong with retention. We’ll break down how the small things (a warm hello, a quick check-in, celebrating milestones) shape the patient journey and set your practice apart. Melissa, before we get into it, tell everyone about your experience in orthodontics.

Melissa Gardner: I’ve spent over 20 years in dental and orthodontics. I started as a clinical assistant, moved into clinical director, then took on the TC role and helped with the front desk, so I’ve touched every aspect of ortho. I had the chance to work with HIP at a practice in my hometown of Amarillo, Texas, and fell in love with what we do. I’ve been with HIP almost three years now. I love orthodontics and dentistry as a whole. We work with smiles all day, and I don’t know a better job than that.

Zach Dykes [02:26]: You’ve been on the front lines, which matters for today’s topic. We get bogged down in the features and the bits and bobs and can get blinded to the actual experience patients go through. So why do you think being patient-centric goes way beyond straightening teeth?

Melissa Gardner: It’s about what we’re changing in their lives. Everyone carries their smile with confidence or a lack of it. For years I didn’t love my teeth and didn’t carry myself with the same confidence. What we’re really doing is building confidence and creating a smile someone carries from graduation to their wedding to their first child to family photos. We have a huge impact beyond the clinical work. We can focus on teeth, technology, and processes, and those matter, but if we lose sight of the people using them, we lose sight of the whole business. People are what matter.

Zach Dykes: It’s easy to get inundated putting out fires, jumping case to case, worrying about closes and same-day starts and no-shows. When someone comes in, are you actually showing up for them? It’s a human experience, and you’re dealing with one of the most sensitive parts of the body. So how does focusing on the full patient experience make a practice stand out today?

Melissa Gardner: It’s everything. I’ve worked with many teams, successful and not. The places that grow the most carry it through every aspect of the office: how it’s lit, how it’s painted, how it feels, whether everyone greets you, whether they remember things about you. People talk about their best experience or their worst, never the ones in the middle. If you plateau and get by, you won’t necessarily fail, but you won’t thrive. To be competitive you have to leave a good impression. You can have great marketing, team members, and systems, but if you don’t make me feel good when I walk in, and I don’t leave excited, you’ll struggle. Realistically I’m leaving sore from a wire change or numb from an injection, so if I still leave feeling great, it’s because of the interactions. That’s when your business succeeds.

Zach Dykes [07:07]: It reminds me of a restaurant in town I’ve gone to since I was eight. The owner knows my whole family, knows my history and what I order, and the same for my wife. You could take that for granted and assume people come back anyway. Him knowing who I am and the waiters going the extra mile, that’s what keeps me there.

Melissa Gardner: You love the food, but if the service were poor, if they never refilled your drink or were never kind, you might order to go, but you wouldn’t keep coming back. We go for a service, but we stay for the feeling, for the way people interact with us.

Zach Dykes: Let’s get into what you call the little things. How can practices implement them, and why do they matter?

Melissa Gardner: It starts on the very first call: how you welcome, ask about their day, and interject normal politeness. Then it’s the coffee bar, the tooth-brushing station, everything bright and clean and welcoming. I’ve seen a practice use a specific scent they’d researched psychologically to make people comfortable. One practice had a board that listed new patients and congratulated people getting their braces off, so you felt prioritized the moment you walked in. Making notes on patients in the clinic matters too. We know which wires are coming in, but what if I asked about your football game, your prom, your aunt’s birthday? Little notes in the chart so the doctor and team can remember, since you may not see the same assistant. Think about a small thing someone did for you, like waving off five cents so you didn’t have to break a dollar. It’s tiny, but it made you smile. Even noticing someone gets the same color every time and asking “are we going with teal again?” It’s small, simple, and it sinks in. They remember the experience that changed their day.

Zach Dykes [11:40]: How would you want to be treated? Would you want to be a number on an assembly line, or would you want them to know you just lost your grandmother and ask how you’re doing? We don’t have enough human connection with phones and everything. We’re connected but not connecting.

Melissa Gardner: In an age of self-checkout, I love talking to the person checking out my groceries because we all crave human connection. Convenience is great, and sometimes I want the self-checkout for five items. But with AI answering every phone, you have to tell it what you need so it can route you, versus a person who can handle your objection right then. We built a world of convenience and now we’re realizing what we lost without that human piece, that smile, that genuine “how are you today.” It’s a factor that will stand out in your business.

Zach Dykes [13:57]: Let’s jump into the first impression. When someone walks in for the first time, what do you want them to feel?

Melissa Gardner: Because this is healthcare, the number one thing is a clean, bright, welcoming environment that sets the tone before they reach the front desk. If it’s dark or dingy, it’s not somewhere you want to open your mouth. The second thing is a smiling face that greets you. I took my son to an urgent care that was clean and bright, but no one greeted us, just a sign-in sheet, and you go through the motions and don’t want to go back. There’s nothing worse than walking in while someone’s on the phone and half-greets you and you don’t know whether to say hi. I’m a fan of keeping phones in the back so the person up front can greet, acknowledge, and take care of you. Those two things make or break whether anything after that matters.

Zach Dykes: Going a step further, coming up to your building, is it clear where people are supposed to go?

Melissa Gardner: Can I find it? Is there a sign?

Zach Dykes: When you go somewhere new, you’re self-conscious and on high alert. Am I in the right place? When you walk through the door and someone greets you, that changes everything. I don’t go to my childhood dentist anymore. It was the glass window and old dark wood, and it felt like “you shall not pass.”

Melissa Gardner: You’re locked out.

Zach Dykes: The dentist I go to now is warm and open. They offer water and make sure you’re taken care of. You feel like part of the environment, not “we’ll get to you when we get to you.”

Melissa Gardner: On the exterior, Google Maps and Siri get confused sometimes, so having that confidence of “this is where you are, we’re here, we’ll take care of you” is key. These may not seem like the most important things for dental health, but they’re hugely impactful for patients coming in and sticking around.

Zach Dykes [18:09]: Now we’ve got them into the practice, past records, everything’s going well, and we’re in the treatment coordinator room. What’s the difference between just presenting treatment and setting a standard that sticks?

Melissa Gardner: The TC room is my favorite room. This is the first interaction that sets the standard for the rest of treatment. If things feel discombobulated, moved from room to room, sitting alone with no one engaging, it can be scary. The number one thing is a streamlined process behind the people so everything runs smoothly and builds trust. The other side is a TC who engages. Not everyone is excited to be there, so I’m going to find out why and find a reason to be excited, whether that’s the colors or the outcome. Everyone has a wall, but with the right space and tone you can break it down. Don’t leave them alone. Be engaged, ask about school or their day, get them to open up, then transition. Make them the star of the show in that room.

Zach Dykes: Creating the atmosphere that they’re the hero and you’re the guide. I love the place I go for medical care, but you wait in the room, tell the nurse what’s wrong, then wait 10, 15, sometimes 45 minutes, and your mind starts racing. Then the doctor comes in and asks what you already told someone. Having a handoff, making the patient feel like they’re the only thing that matters, that brings the walls down.

Melissa Gardner: Leaving someone alone in silence lets their brain take over. Especially in ortho, they’re here for braces, it’s simple. A TC handoff like “this is Jacob, he’s excited about braces, a little nervous because he plays football, and he’s hoping to be done by senior year” is perfect. Do it right in front of them. It doesn’t have to be secretive. It puts them at ease, builds confidence that you listened, and lets the doctor go straight into what they need. Not asking the same questions every time is really important.

Zach Dykes [23:59]: Say they’ve been started and we’re into mid-treatment visits that can feel routine. What can practices do to keep the pizzazz?

Melissa Gardner: We know them, they’re our patient, and we should be excited to see them every time. These are the people who bring in more people. Acknowledge and remember them. I’m a huge fan of notes. Go back and look at what was done last time, the rubber bands, the wire, and in a different color or italics, a note of what was discussed in their life last time. Then you can ask about it and make them feel as special as the day they started. Hype up colors for the younger kids. What color today? Do you have a game? Want to match your team? It’s a mundane appointment, but those little touch points re-engage them and remind them why they chose you.

Zach Dykes: How would you train a team not to go into autopilot during check-ins? Some people just aren’t good note-takers.

Melissa Gardner: It takes repetitive accountability and consistently talking about it. Most practices have a morning huddle. Reiterate the importance, because people need to understand the why to get to the how. Center your huddles on the patient experience. Standardize the note so it always includes the date, what was done, the wire, and a special or conversational note, so they know something has to go in there. Make good notes the standard, because they’re the lifeblood of the practice. If it’s missed, don’t let it get swept under the rug.

Zach Dykes: It just takes practice, like anything. The more you do it, the more comfortable it gets. The first time won’t be perfect. Like this live stream, we keep doing it and it gets better.

Melissa Gardner: Practice makes permanent. There will be bobbles, and nobody’s perfect. Even if I didn’t add a personalized note last visit, I can scroll up and find something to engage on. As long as we get 1% better every day, it becomes muscle memory, the standard of how you work.

Zach Dykes: If you get out of your head, you make the patient feel like the star. Especially for kids, they want to be seen and heard, and you might be the only place that happens in their day.

Melissa Gardner: My son is a senior this year and was in braces. From a mom’s perspective, that appointment means more to them than you think. He’d ask when his next appointment was, and start wearing his rubber bands the week before because he knew it was coming. He’d wonder what color he’d pick. It consumes them. This isn’t a shot or blood work. It’s new colors, a new wire, a step closer to the smile they started six to 12 months back. Remembering that makes it easier to put in the effort on notes and questions.

Zach Dykes [33:54]: Let’s talk about retention, because it’s huge and often overlooked. Why is it such a critical stage?

Melissa Gardner: It’s a massive stage. Sometimes we think “they’re done, we fulfilled our promise.” But this is a long-term investment. The likelihood of not wearing retainers or winding up back in treatment is high, especially as we get older. I want to make an impact so they say “that was amazing, I’m going to keep wearing my retainers,” and tell everyone to come here because they weren’t pushed aside at the end. They sat me down, made sure the retainers fit, made a big deal about how great my teeth looked, and explained why retainers matter. And if they do need retreatment, I want them to come back to me first. Patients have other options. Retention is the end of active treatment but not the end of the referral source or their experience with maintaining their smile.

Zach Dykes: Going at it without guilt or shame if they have to come back is a big point.

Melissa Gardner: Huge.

Zach Dykes: If they feel like you’ll be disappointed in them, they’ll just go somewhere else. But if it’s “you’re part of the family, we want to take care of you,” you set them up to come back. Let’s talk about helping them finish strong. What are simple ways to make the end of treatment feel special?

Melissa Gardner: It’s the overall experience, even at the appointment before the debond. Make a big deal walking up to schedule: “we’re getting your braces off next time.” Acknowledge if they finished early, or if they finished late say “we put in an extra three months and I’m so glad we got you where you wanted to be.” On debond day, the board or the front-desk person knows you’re here for your debond. As a TC I tracked my patients’ debond dates and would run back to the clinic or up to the front to see the smile we created. People loved that someone came running to see them. Have a debond gift, whitening gel for the retainers, a T-shirt, a swag bag. I love photos, a picture with the doctor, a photo booth, a cool accent wall. They spent a year or more with metal in their mouth, sore every six to eight weeks, wearing rubber bands, avoiding favorite foods. Give them some popcorn, a Jolly Rancher, something to make it a celebration. We made the experience amazing at the beginning, and now we bring it home.

Zach Dykes [39:30]: Has doing a celebration at the finish line helped with long-term loyalty and referrals?

Melissa Gardner: Absolutely, all day long. That’s your highest form of referral. You take that picture with the doctor, they post it, or you post it on Facebook if they allow. We live in a world of FOMO. If I had braces and my practice just said “congratulations, wear your retainers,” and then I see someone else taking a smiling selfie with their doctor and raving about the experience, I’ll wish I’d gone there, or take my kid there, or recommend them even though I didn’t go. They become an advocate. People talk about their best experiences. If you make it a true experience, they’ll talk about it every day. Everyone who’s an orthodontist can straighten teeth. The real question is, can you make somebody fall in love with having had braces?

Zach Dykes: What if you made a note that a patient couldn’t eat their favorite candy, like Butterfingers, during treatment?

Melissa Gardner: With braces it’s not advised. I won’t say they don’t do it, but it’s not advised.

Zach Dykes: On the debond, they finally get to eat the candy they like. Little things like that. You know them, you’ve spent that much time with them, and you’re enjoying their success. Getting to debond takes a lot of work.

Melissa Gardner: It does. One practice had candy machines with Jolly Ranchers, gumballs, and Starburst so patients could turn the crank and pick their own when they got their braces off. Others keep mini candy bars like Butterfinger or Snickers, the things you’re not supposed to have during treatment. You could ask the day before the debond, “what’s your favorite candy you haven’t been able to eat since you got braces?” and have it ready in the back. How impactful is it that you asked? One practice even had a popcorn machine, so you got a bag of popcorn when your braces came off. It probably drove the patients still in braces to wear their rubber bands because they wanted them off. Small things, large impact.

Zach Dykes [43:50]: Let’s talk about the human challenge of losing sight of the patient. What makes it easy to lose sight of the journey?

Melissa Gardner: We’re all human with stressors and pressures. When we’re stressed or having a bad day, or we had a difficult or angry patient, or it just feels mundane putting in another wire, those things can pull us away from focusing on the patient. I don’t want to say we’re playing a role, because we genuinely care, but my role is to take care of every patient at the highest level. I have to set my own state aside for that time. Take a breath, reassess, get a coffee, clear your mind. That person could be going through the same thing or something ten times worse. Do for them what you’d want done for you on a bad day. I believe in karma. This is their moment, not mine, and we have to be there for them and give them the experience we promised.

Zach Dykes: When you help other people feel good, you feel good.

Melissa Gardner: There’s nothing better than making a positive impact on another person and knowing they’ll carry it through their day or pass it on.

Zach Dykes [47:23]: Last question. How do you keep yourself focused on the fact that the work is about people, not just teeth?

Melissa Gardner: It should always be front of mind. I’ve never seen teeth walk themselves through a door. When you look at someone’s teeth, there’s a face and a person attached. We’re serving people. Yes, we take care of their teeth, but those teeth are nothing without the person, and the purpose is a lasting smile for the rest of their life. I love teeth, but if you’ve seen extractions, they’re not great when they’re not attached to a person. Keep the people front and center and make the teeth the second priority, and both get taken care of.

Zach Dykes [48:36]: That’s our live stream today. Subscribe to the GrowOrtho Podcast and the GrowDental Podcast for more content to help you grow your practice. As the saying goes, the secret of getting ahead is getting started, so get out there and make the changes you want to see in your practice. This has been Zach and Melissa. Thanks for watching the GrowOrtho live stream.

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