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Growing Your Invisalign® Practice from the Inside Out

Three Key Principles to Starting One Invisalign Case Every Day

Let me start by asking a simple question – where do Invisalign patients come from?

Expensive marketing campaigns?

Social media posts and fancy Facebook lead-generating ads and sales funnels?

That poster you hung on your wall and those brochures you placed on your front counter in hopes the patients will ask you about it?

If you think these things are going to fill your schedule with patients lining up for Invisalign consults, then I am going to challenge you to think differently.

I want to get you excited about the idea that all the Invisalign patients you could ever want are already inside your practice.  

In a small rural town with a population of only 7000 people, I have been able to achieve and maintain Platinum status since 2017.

In this article I will share with you the 3 Key Principles I used to grow my Invisalign practice from the INSIDE OUT – without any fancy marketing campaigns or rock bottom pricing strategies.  

My Invisalign journey began in 2008 when I completed Level 1 certification, which allowed me to do a handful of cases per year.  That was until 2017 when everything changed. In 2017, I started over 100 cases – with 46 of those cases started in the last 2 months of the year.  And yes – I did this without any external expensive marketing campaigns and no rock bottom pricing. In 2018, I started 167 cases and worked 151 days – over one case for every day I worked, and I’ve never looked back.  So what changed?

Principle #1  

Changing YOUR MIND is the first step

“If it’s been done before it’s probably possible.”

One of my favourite quotes from Zig Ziglar.

Over one weekend in late 2017 after a series of “fortunate” events including attending a minor hockey league game with my son and downloading a chance book to my Kindle, a lightning bolt of inspiration hit me.

I was inspired both by Zig Ziglars’ quote (which appeared in the book I was reading) and by what other dentists I looked up to and admired were achieving.

I was inspired to be a dentist who started one Invisalign case every day.  

Not only did I know Invisalign clear aligners to be a fun part of practice, but I also knew starting a case every day would more easily allow me to reach the financial goals for my practice.

Your mind is powerful and until you really commit and believe you can achieve the unthinkable – like starting an Invisalign case every day – you won’t.

Changing your mind has to be the first step.  That’s all I changed in three days over that one weekend in 2017, and I started 46 cases of Invisalign treatment in the next two months.

I knew I could be a dentist who started one Invisalign case every day because others had done it – and if it’s been done before, it’s probably possible.

I went from thinking “there is no way I can start more Invisalign cases, there just isn’t that much opportunity” (scarcity thinking – which we will get to in a moment!) to believing in myself and my team that I absolutely could do more…and we did!

I know what you are thinking – “Is she serious? Just change my mind and magically all the Invisalign cases will appear?”

Stay with me because yes, over that weekend, I made the mental commitment but at the start of the week was where the rubber hit the road so to speak, and I had to put action to my thoughts.  That’s where principal number two comes in…

Principle #2  

Get Engaged in Your Practice

If you are anything like I was, I loved running back to my office to check social media, my phone, the stock market, read the latest article on the newest bond, or who knows what else, while I was waiting to begin treatment for my patients. And I was a master of hiding from my hygienists –  What an interruption in my already busy day!

Just let me do the dentistry and do not stretch me outside my comfort zone and I’m happy…

Unfortunately, what I didn’t recognize was that by doing that I was missing huge opportunities, and if I wanted to start one case of Invisalign treatment every day, I could no longer afford to be disengaged. I could no longer afford to take my patients and their needs for granted.  But to do that I had to put some effort in.

What do I mean by this?

I put my phone down and scoured every chart of every patient who was in my office today.  I was actively looking for opportunities to talk about Invisalign clear aligners. Who could I talk to today?

Checking email? Forget it. Now I checked all the hygiene charts looking for opportunities!

Surfing the web? Not anymore. I needed to dig deep into all the restorative charts.

What I’m getting at is that opportunities don’t just happen – you create them!

You need to become keenly aware of the outstanding dentistry and opportunities that are in your office TODAY!

I bet you are thinking, “My assistants and hygienists already do a chart audit and tell me about outstanding dentistry.” And you know what? Mine did too!!!  But finding patients to talk to about Invisalign clear aligners is much different.

There is something to be said for YOU – THE DOCTOR – getting intensely engaged with your patients.  Reading your last notes yourself, reviewing your last x-rays or even better – the last photos – and getting yourself mentally prepared for another conversation is very powerful.   Your team will start to notice the shift too – and trust me – they will like it!

Get focused for a revisit of the already diagnosed dentistry, and if you want to start more Invisalign cases, get focused on who you can talk to about Invisalign clear aligners today.  Don’t underestimate the value of being prepared for those conversations.  Preparedness brings confidence.

Once I was prepared, once I knew with a laser focus who I was talking to today and once my team was prepared for me to have those conversations, you would be surprised how often those patients said “YES”!

But the truth is I had to find those opportunities because they weren’t just going to be handed to me on a silver platter.  

I had to put the work in and get engaged. 

We have a specialized set of skills that only we as dentists possess and that we as dentists only get to practice while we are at work! So make hay while the sun shines!!!  Get out of your personal office, get off your phone, turn off the TV, quit making phone calls, stop returning emails, and quit checking Facebook.

Do what only you can do: provide dentistry and get engaged with your team and your patients!  Everything else can wait.

Getting engaged also means (and yes I am gonna say it) you need to have a motivating, impactful, laser focused and empowering morning huddle.

My first day back in the office after that life-altering weekend in late 2017 began with a morning huddle like I had never had before.  And the day ended with four Invisalign case starts and another three on the schedule to start later that week.

To run a great meeting, my suggestion is for you as the doctor to be the happiest, most positive and overly energetic person on your team. You set the tone for that in the morning meeting!  If you come to work tired and unfocused, your team will follow suit. And no, I don’t believe this can be delegated.  You are the leader and you need to lead the charge, especially in times of change and new goals.  To reach new heights, you must be willing to go outside your comfort zone.

I would suggest every doctor needs to meet with their main assistant(s) and head scheduler in the morning. The agenda needs to be crystal clear: you now have a daily goal and intention of starting one Invisalign case every day and you need their help to reach this goal.  Who are you going to talk to today about Invisalign clear aligners and what is the plan if they say YES?

Get your team happy, get them motivated and get them believing in you! End with high fives, fist bumps or some other positive affirmation of the day, and start the day with good energy and clear intentions.

Trust me, there is no better way to start the day than by celebrating an Invisalign case start from yesterday!  

So get out of your personal office, stop hiding, take charge, get excited about the future and see the magic that follows.

Now you might be thinking, “Ok, I can get excited about the goal and start a mindset shift, and I can be more engaged with my practice, but you still didn’t answer the question you began with: where do these Invisalign patients come from?”  This leads me to principle number three.

Principle #3 

Invisalign patients are in your schedule already! (you just need to know how to talk to them)

In order to start more Invisalign cases, you have to believe that diagnosing a malocclusion is just as important as diagnosing a cavity.  Period.  Read that again if you have to.

Until we as dentists understand how to talk to patients about their malocclusions and the health benefits of straight teeth, we are letting a huge opportunity inside our practices pass us by. If the only way you know how to bring up a malocclusion is to ask if your patient has ever thought about straightening their teeth, you are going to hear a lot of “no”s. Why?  Because patients THINK Invisalign clear aligners are about cosmetics (and they aren’t that VAIN! And plus, isn’t that expensive???). It’s your job to help them understand it’s about so much more than that.

Straight teeth are about much more than cosmetics.

Understanding the importance that straight teeth play in improving a patient’s overall oral health was a game changer for me and my team and what allowed us to take our Invisalign practice to the next level.

That patient with crowding and cavities? There is an opportunity to talk about the health benefits of straight teeth.

That patient with crowding and gum disease?  There is an opportunity.

That patient with recession on a rotated canine? That Class 2 patient with wear who needs a nightguard? That patient with crowding who needs an implant?  That patient who has a deep bite, no overjet and daily headaches? The patient who broke the buccal cusp of a tooth in crossbite?

All of these patients are opportunities to talk about the health benefits of straight teeth! And these are the patients we see all day long in our practices.

Teeth that fit together better are easier to clean and last longer. It’s really as simple as that.

Seventy-five percent of the adult population is walking around with a malocclusion just waiting for us to diagnose! If you see eight hygiene patients in one day, six of them have a malocclusion. You only need one to say yes to Invisalign clear aligners today…

One out of six is a 16% case acceptance rate! (I hope this is looking more doable now!)

There is more than enough crooked teeth to go around.  Think abundantly!  Scarcity thinking is believing there are only so many people in your practice who will say yes to straightening their teeth, or that you will somehow run out of patients to talk to about the health benefits of straight teeth. It simply isn’t true.

If DTC orthodontics has taught us anything, it’s that the demand is there, and we just need to be more intentional at understanding the demand and understanding what our patients’ goals are. We have to be more intentional about talking to our patients about it and educating them on the health benefits of straight teeth.

So growing your Invisalign practice does not need to mean expensive marketing plans to attract new patients, or rock bottom prices to compete with DTC aligner brands.

Growing your Invisalign practice from the inside out simply means talking to your existing patients about the health benefits of straight teeth.

And the really good news is if you get intentional about finding the opportunities in your own patient population, those patients already know you, already have a relationship with you and probably most important, already trust you.  These patients are much more likely to say YES and feel good about their decision.

“To get things you’ve never had you must do things you’ve never done.”

This is my all-time favourite quote and through this article, I hope I have given you the nudge you need to go after those things.


About Dr. Terri Pukanich

Dr. Pukanich graduated from the University of Alberta dental School in 2002. She bought her first and only practice in 2003 when she was just 25 years old. Over the last 16 years she successfully grew her practice from a 4 treatment room, 1 doctor office to a 17 treatment room, super GP group practice – all in a small rural town of 7000 people. She is passionate about creating dental work environments that have tremendous impact on patients and team members and where everyone has fun! Along her journey she has worked with the biggest names in dental coaching and has spent over a million dollars on developing her practice. She learned the secrets to implementation and execution of the most effective strategies. She is now CEO and Founder of Dental BossLady where she helps women in dentistry create a profitable and fulfilling practice while having more fun and making more money. She is a Platinum Plus Invisalign provider and a Key Opinion Leader for the American Academy of Clear Aligners.


Invisalign®, the Invisalign logo, and iTero®, among others, are trademarks and/or service marks of Align Technology, Inc. or one of its subsidiaries or affiliated companies and may be registered in the U.S. and/or other countries.
The opinions expressed in this article are those of the author and may not reflect those of Align Technology, Inc. The author was paid an honorarium by Align Technology, Inc. in connection with writing this article.®

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