Program Guide

My Smile Choice™

The complete, back to front solution that allows you to successfully, confidently and profitably offer 3 levels of clear aligner treatment to grow the adult segment of your practice.

Let’s Remember What’s Important

Goal

Grow your practice by increasing the number of clear aligner case starts – NOT by discounting full service, but by offering different levels of treatment to potential patients. Let them hear and understand your recommendations. They will then be empowered to choose the treatment they want and can afford. Ultimately providing a higher level of care and service for your community.

Who are we targeting with My Smile Choice™?

The target audience for this program is any adult who thinks they just have a tooth or two they want fixed. This is the group being targeted by direct-to-consumer orthodontic companies. 

Why is this program important for you and your community?

Most people think treatment will be quick and inexpensive and are not aware that they may need more comprehensive treatment. This is because the general public does not understand orthodontics and what it really takes to move “a tooth.” Mail-order aligner companies are capitalizing off this general misunderstanding.

More people than ever want clear aligner treatment, but they aren’t calling or scheduling consults with you. Your community has already been convinced it’s too expensive (upwards of $8K) for treatment through you. You can thank the insistent advertising against you over the last 5 years. Adults have been conditioned to think that you are not an option for them!

And it’s going to get worse. SmileDirectClub™ is making it more and more convenient and affordable for the growing number of adults who want a better smile to get it. They recently announced PARTNERSHIPS with CVS, United Healthcare and Aetna to make aligner treatment as easy as stopping by the drugstore for an out of pocket cost of under $1,000 (after insurance):

• CVS – A “SmileShop” next to the pharmacy will give SDC more credibility. It will also give the appearance that orthodontics is more of a commodity than a specialty.
• UnitedHealthcare & Aetna so people can apply their insurance up front

By implementing My Smile Choice™, you can help your community and grow your practice by:

1. Proactively attracting adults with cosmetic treatment and a free smile evaluation.
2. Providing an exam & diagnosis to explain why comprehensive treatment may be best.
3. Allowing them to make an educated decision between comprehensive or cosmetic (partial) treatment.
4. If cosmetic treatment is chosen, treat them accordingly within the strict parameters of a defined and documented program.

A note before we get started…

This program was initially designed for Invisalign® providers. The recommendations in this program maximize the features and benefits of each Invisalign® case type in relation to each cosmetic tier while maintaining profitability.

We encourage you to follow the program as recommended. You will remain profitable and be able to offer all the benefits of the My Smile Choice™ program without incident (such as the potential of incurring extra fees, etc.).

Ultimately, you are the prescribing doctor. It is up to you which case-type you use for each tier, as long as you fulfill the program as defined for the patient.

If you use a different clear aligner system in the office, we will help you implement the program to meet your specific practice needs. Make sure to let us know what system you use and we will schedule a call to get started.

Starting with a free consultation (or what we call a Smile Evaluation), you offer your community 3 levels of clear aligner treatment. The My Smile Choice™ program somewhat mirrors the experience someone might have had in an Invisalign® store. This brings consistency and familiarity in the marketplace. However, the details of this program are specifically designed for successful implementation in an orthodontic office. The My Smile Choice™ program includes all the tools you need to set proper expectations for the patient. Here, we will lay out the details of each tier as it pertains to you and your team:

The next section gives an overview of each tier. We will discuss more details (like pricing!) later in this guide.

Minor Treatment – Level 1

Minor treatment (up to 14 aligners) would typically be used if the patient wants to “touch-up” their anterior teeth. It’s also a great option if the patient just wants minor movement to enhance their smile or maybe “tuck in” a single tooth, but aren’t looking for perfectly straight front teeth. It all starts with a free Smile Evaluation. Once the consult is complete and the patient chooses Minor treatment:

• Records are taken at the initial consultation. Ideally, a scan was already taken during the consult so you could show a simulation. See how to best show a simulation for Minor treatment in the Consultation Scripting Guide.
• Invisalign Lite® is recommended for Minor cases – this will allow up to 14 aligners and the use of attachments and IPR (Interproximal reduction).
• ALL aligners are given to the patient.
• Align Technology, Inc. recommends that each aligner be worn for 1 week at a time. Therefore, treatment is approximately 14 weeks.
• There are only 2 treatment appointments!
  • Initial Appointment – After the Smile Evaluation, the patient will have their initial appointment where you place any attachments and/or do IPR, if prescribed.
  • Final Appointment – Patient comes back for the second appointment to remove any attachments if needed and receive their retainer and whitening.
• In your ClinCheck®, you’ll need to plan for attachments to be placed and any IPR to be done at stage #1.
• There should be no reason to “reboot” the case during Minor treatment. It is noted in the Minor & Cosmetic Patient Consent Form that these are the only aligners they get and they will lose their investment if they stop wearing the aligners for any segment of time that results in the remaining aligners not fitting properly. The ONLY exception that’s recommended is if, upon your evaluation, you find your treatment plan resulted in unwanted/unplanned movement that results in an unhappy patient. In this scenario, we recommend you do right by the patient and submit a refinement, but again, that is at your discretion.
• To add value to treatment, free teeth whitening & a free retainer (of your choice) is given to the patient. You’ll determine your whitening & retainer specifics when you review the Integration Workbook with your team. There’s also an option for the patient to upgrade their retainer for a fee.
• The 1-year warranty allows for any minor relapse that might happen while wearing a retainer to be corrected within 1 year of starting initial treatment.
  • Currently, Invisalign Lite® allows for 2 refinements of up to 14 aligners each within 2 years. So IF a warranty is claimed there should be no extra cost to you.
    NOTE: if treatment was originally deemed a “partial treatment” (i.e. teeth were not fully aligned in 14 aligners) then the refinement would only allow the teeth to move to the final position of the original ClinCheck® finish.
  • If a warranty is claimed, the patient must bring their retainers with them for their appointment. Do not ask the patient if they have been wearing their retainer. This just gives an opportunity for the patient to fib and puts you in a hard spot. You’ll inspect the retainer and discuss treatment (or no treatment) based on your inspection. Ultimately, the decision to do another round of treatment for that patient is at your discretion.

Comparing My Smile Choice™ Minor Treatment with mail-order aligner programs

Most online aligner companies allow for 20 aligners, but NO attachments & NO IPR. The movement you get with Invisalign Lite® (14 aligners), attachments & IPR allows you presumably the same, if not better, movement in a faster amount of time!

Cosmetic Treatment – Level 2

Cosmetic treatment (up to 30 aligners) would typically be used if the patient wants to straighten their anterior teeth. Small movements to the posterior teeth can be achieved (such as uprighting molars), but A-P (anteroposterior) changes would not be made. It all starts with a free Smile Evaluation. Once the consult is complete and the patient chooses Cosmetic treatment:

• Records are taken at the initial consultation. Ideally, a scan was already taken during the consult so you could show a simulation. See how to best show a simulation for Cosmetic treatment in the Consultation Scripting Guide.
• The Invisalign® Comprehensive Package is used for Cosmetic cases – the treating doctor will need to request that the technician align the front teeth as best as possible within a maximum of 30 aligners in the ClinCheck®.
  NOTE: Keep an eye out for posterior rotations, extrusions etc. Eliminating these types of movements can reduce the number of aligners in a case.
• Align Technology, Inc. recommends that each aligner be worn for 1 week at a time. Therefore, treatment is approximately 30 weeks.
• There are 3 treatment appointments:
  • Initial Appointment – After the Smile Evaluation, the patient will have their initial appointment when you place any attachments and/or IPR, if prescribed.
  • Mid-Treatment Appointment – there will be 1 appointment mid-treatment. So if there are 30 total aligners, you will give 15 aligners to the patient at a time.
  • Final Appointment – Patient comes back for the third/last appointment to remove any attachments if needed and receive their retainer and whitening.
• In your ClinCheck® we recommend you plan for all attachments to be placed and IPR to be done at at stage #1 and/or mid-treatment.
• Whereas the Minor option doesn’t allow for any further treatment, the Cosmetic option (utilizing Invisalign® Comprehensive) allows a patient to continue treatment by requesting an additional 15 aligners to be done for an extra fee of $699 (see Consult Laminate).
• If a patient is non-compliant and the remaining aligners no longer fit, one option is to allow the patient to request their extra 15 aligners for $699 “early” so they don’t completely lose out on their investment.
• The ONLY exception that’s recommended is if, upon your evaluation, you find your treatment plan resulted in unwanted/unplanned movement, resulting in an unhappy patient. In this scenario, we recommend you do right by the patient and submit a refinement, but again, that is at your discretion.
• To add value to treatment, free teeth whitening & a free retainer (of your choice) is given to the patient. You’ll determine your whitening & retainer specifics when you review the Integration Workbook with your team. There’s also an option for the patient to upgrade their retainer for a fee.
• The 2-year warranty allows for any minor relapse that might happen while wearing a retainer to be corrected within 2 years from when initial treatment started.
  • Currently, Invisalign® Comprehensive Package allows for an unlimited number of aligners to be used within 5 years. So IF a warranty is claimed there would be no extra cost to you.
  • This also allows you to continue treatment at no cost to you if the patient at any time would like to upgrade their Cosmetic treatment to Complete treatment.
    NOTE: The fee you quote for Complete (full) treatment is noted in the Minor & Cosmetic Patient Consent Form so that if the patient wants to “upgrade”, they can pay the difference in cost and proceed with Comprehensive treatment.
  • If a warranty is claimed, the patient must bring their retainers with them for their appointment. Do not ask the patient if they have been wearing their retainer. This just gives an opportunity for the patient to fib and puts you in a hard spot. You’ll inspect the retainer and discuss treatment (or no treatment) based on your inspection. Ultimately, the decision to do another round of treatment for that patient is at your discretion.

Complete Treatment – Level 3

This is your typical full-treatment option (unlimited aligners) that you currently offer in your practice. You would proceed with your typical protocols for this type of case as it will vary based on the complexity. However, here are your basic protocols for Complete treatment:

• Records are taken at the initial consultation. Ideally, a scan was already taken during the consult so you could show a simulation. See how to best show a simulation for Complete treatment in the Consultation Scripting Guide.
• Invisalign® Comprehensive Package is used for Complete cases.
• Don’t forget to give whitening at the last appointment! To add value to treatment, free teeth whitening & a free retainer (of your choice) is given to the patient. You’ll determine your whitening & retainer specifics when you review the Integration Workbook with your team. There’s also an option for the patient to upgrade their retainer for a fee.
• The 5-year warranty allows for any minor relapse that might happen while wearing a retainer to be corrected within 5 years from when initial treatment started.
  • Currently, Invisalign® Comprehensive Package allows for an unlimited number of aligners to be used within 5 years. So IF a warranty is claimed there would be no extra cost to you.
  • If a warranty is claimed, patient must bring their retainers with them for their appointment. Do not ask the patient if they have been wearing their retainer. This just gives an opportunity for the patient to fib and puts you in a hard spot. You’ll inspect the retainer and discuss treatment (or no treatment) based on your inspection. Ultimately, the decision to do another round of treatment for that patient is at your discretion.

Pricing for Minor treatment & Cosmetic treatment are fixed for every participating practice. This allows My Smile Choice™ to market effectively to your community while allowing you to stay competitive & profitable. The pricing for Complete treatment is displayed to the public as a range. This allows you to keep your current comprehensive pricing or determine your pricing based on complexity.

Before we get into the actual pricing, it is first important to know WHY we have priced each level the way we have. There is a psychology to a tiered offer. It has been shown over and over that most often people will choose the middle tier when given 3 options online. However, in our program testing we have found that a very significant percentage choose Complete treatment. We believe this is because the person knows treatment pricing before walking into the consultation (see case study below). This allows them to be fully present and engaged in the conversation on why Complete treatment may be best.

CASE STUDY:

During our test phase of this program, we had an office invite back 60 people from past consults who never started treatment where full treatment was the only option given. Eight (8) people set up a second consult! They all were shown the details of My Smile Choice™ up-front, including pricing. We had 5 immediate starts & 3 delayed starts due to dental work. Interestingly, 2 of the starts were Cosmetic (the middle tier) and 3 were Complete treatment! Again, these patients all declined full treatment at the first consult. The practice owner/doctor theorized that in their traditional consult method, where price is given at the end, patients cannot truly listen and understand the value of comprehensive treatment because they are just wondering if they can afford it. When patients know pricing up front, they know they can afford some level of treatment and they become much more engaged in the discussion of why Complete treatment is best for them and their future.

The current payment options you have in the office can certainly be adapted for the program. However, with the addition of new service options, Minor & Cosmetic treatment, now is a perfect time to modify or add options that favor you.

The following are the payment options we recommend you offer patients for each tier. We have specifically designed this program so that it offers the patient affordability while maximizing profit for you. You’ll discuss these payment options with your team to determine the best plan for implementing the pricing within your practice.

Minor Treatment Payment Options

Since all the aligners are given to the patient in this option, it is ideal that you get paid up front. That is why we suggest only two payment options:

1. Pay in full with no discounts given.
2. Finance $2,495 through 3rd party financing only.¹ We recommend offering the extended financing option (36-60 mo.) since that has the lowest processing fee for you.

Cosmetic Treatment Payment Options

The Cosmetic Treatment option will be a popular choice for patients. Therefore, we want to make sure people can afford it while also making sure that you are compensated properly for your work. So this option takes a different approach than you are used to. This option rewards a person significantly for paying in full upfront, or allows reasonable payments made over time. Here are three payment options for Cosmetic treatment:

1. Pay in full ($3,795) with no discounts given
2. Finance in-office at $187/mo for 24 mo
   1. If you multiply $187 x 24 mo, you are paid a total of $4,488 (not $3,795)
   2. Benefit to the patient: they get affordable monthly payments similar to what a 3rd party financing institution would give but they won’t get a hit to their credit or deal with approvals.
   3. If you want to show a patient that their payment would be similar if they finance through a 3rd party, CareCredit® has an easy calculator you can use to show them. https://carecredit.com/payment_calculator/
      1. Enter $3,795 into the calculator
      2. Note the 24 month, monthly payment that includes interest (on the right side) is $184/mo.
   4. NOTE: no down payment is required for the in-office financing option. This would most likely be the only option in your practice that won’t require a downpayment. To make sure you have enough funds to cover lab fees, you can easily track how many people pay in full throughout the month by using our Treatment Tracker.
      INDUSTRY TREND:
      Many orthodontic offices are now offering no (or very low) down payments and regularly extending monthly payments past treatment time to make it affordable. The amount of people who default on payments is said to be extremely low to the point it’s “just a cost of doing business.” If this makes you uncomfortable, you could offer this option on a case by case basis. If you get a “feeling” that the patient would default, certainly just offer options that are comfortable for you.

       

3. Finance $3,795 through 3rd party financing.¹ We recommend offering the extended financing option (36-60 mo.) since that has the lowest processing fee for you.

Complete Treatment Payment Options

The pricing for Complete treatment may vary based on complexity or the pricing structure you typically have in the office. We recommend 3 payment options:

1. Pay in full w/a courtesy discount (typically 5-7%)
2. Downpayment w/installments (usually over 24 months, but many practices are extending installments past treatment time to make them more affordable for the individual patient)
3. Outside financing (typically 36 – 60 months extended financing ¹)
   1. Ideally, this should reflect what you currently offer for comprehensive treatment. Insurance would also be handled as you typically would.

Tandem Treatment™ is when a parent/guardian goes into aligner treatment at the same time as their child enters aligner or bracket treatment. We’ve all heard moms say, “I’ve wanted to fix up my smile for a long time, but I’ll wait until my kid(s) are done with treatment and then I’ll definitely do it.” Unless, of course, other things like a family vacation, a new washer & dryer, or anything else that may come up, comes up.

When a parent can do treatment with their child, it enhances the experience for everyone. Compliance tends to be better as there is accountability between the two and there is a sense of teamwork and accomplishment that creates a bond during their smile journey. It also maximizes convenience for the parent as they are already at the office for their child’s appointments. Everyone wins when a parent goes into treatment with their children. That’s why practices promote Tandem Treatment™ whenever possible.

There are many points of affordability for the parent when it comes to Tandem Treatment™.

1. They might not be able to afford two Complete/comprehensive treatments, but they might be able to afford full treatment for their child and do Minor or Cosmetic treatment for themselves.
2. By using outside financing in this instance, they can typically pay the same monthly payment they would with just their child’s treatment by paying it over 3-5 years (which is how long they’d make payments to you if they were treated one after the other).
3. The biggest incentive to do Tandem Treatment™ is that it offers an extra discount on anyone in the family who goes into Complete (comprehensive) treatment that is only available when they start at or very close to the same time as their child/children. You will need to determine the discount you will offer. We suggest offering 10% off at the initial consultation and let them know that lowers to 5% (or lower) if they start after their child.

There are two ways to grow an orthodontic practice – increase your conversion rate and/or increase the number of new patient consultations. This program does both & we provide a Treatment Tracker for easy record keeping!

Increase Conversion Rate

Most offices track how many overall consults turn into actual treatments. However, this number usually includes both kids & adults. We have found that if you break out the conversion on kids vs adults, you’ll most likely find that your conversion rate on adults is lower than thought. This is because adults see orthodontics as optional and usually go on 2 or even 3 consultations. But the conversion rate on kids is much higher, which hides this growth opportunity in your practice!

To track the increase in conversions, you want to create a baseline of where you are today. Here are the numbers you need to track:

• Total number of adult consultations done monthly over the last two years.
• Total number of adult treatment starts broken out monthly for the last two years.
• Number of adult treatments that were Invisalign (or clear aligner option) vs braces

It’s good to run the reports in a monthly format, if you can, so that you can look for trends on good vs slow months and plan accordingly. But to calculate the overall conversion rate, you can use the yearly number. Here’s the equation you’ll use:

#of Adult Tx Starts / # of Adult Consultations = Adult Conversion Rate (%)

Then run these same reports monthly or quarterly to make sure that you are seeing growth. If you aren’t, then you need to evaluate your consultation verbiage and your marketing efforts. We’ve given guides for both to make your My Smile Choice™ as effective as possible.

Increase New Patient Consultations

You need to let your community know that you are offering choices that rival the convenience and affordability of other ortho options on the street! My Smile Choice™ gives a step-by-step Marketing Plan for in-office marketing, local marketing & online marketing. Your subscription includes customized brochures, pass-along cards, flyers, email templates, information & graphics for your website, a My Smile Choice™ microsite and social media content licensed for your use as long as you are a member of the My Smile Choice™ program.

• How will I keep track of our My Smile Choice™ patients from our regular patients? This is important so that you know who to charge for “extra treatment”, etc. The best way to do this is to create a distinguishing factor in your Practice Management Software (PMS).
  EXAMPLE: For Dolphin users, the top of a patient’s treatment card can be customized with specific colors. You can designate a specific color for Minor and Cosmetic patients. Typically, offices already have a color designated for full, aligner treatment. This would be your Complete color.

• When a patient is referred by a General Dentist for a specific issue needing comprehensive treatment, should I share My Smile Choice™ with them?

  YES! For 3 reasons:

  1. During the consultation, if you feel the patient needs comprehensive treatment, that should be your recommendation. You should also build value for the patient as to why it is important they proceed with Complete treatment (as shown in our Consultation Scripting Guide). Most likely they are wanting to fix the same issue and therefore will choose Complete treatment.
  2. When patients are informed about My Smile Choice™, they can tell others. So while they are wearing their aligners, they can discuss the program with friends, family and colleagues, and potentially refer more people to your office!
  3. If the patient chooses Minor or Cosmetic Treatment instead of Complete Treatment, then it means that their goals are very different from that of their referring dentist. If only comprehensive treatment is offered to these patients, then they will most likely not move forward with treatment. In these cases, we recommend you call or email the referring dentist so they understand that you made a full recommendation and agree with their assessment, but the patient chose differently.

Congratulations!

You should have a pretty good idea of how this program is run, but there are details that need to be customized for your practice. This will be done at your meeting when you go through the Integration Workbook. Please refer to your Integration Plan for next steps.