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Office Visit: Making Communication Make Sense Benjamin Lund, Editor, Orthotown Magazine

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A strong focus on communication and an unwavering interest not only in teeth but the patients he serves help make Dr. James D. Bryan's West Coast practice a success.

by Benjamin Lund, Editor, Dentaltown Magazine

Welcome to the second installment of Office Visit, where we visit a Townie's office and profile his or her equipment, office design or unique practice philosophy. If you would like to participate or nominate a colleague, please send me an e-mail at ben@farranmedia.com.

This month, we paid a visit to Dr. James D. Bryan's practice, Bryan Orthodontics in Mission Viejo, California. Dr. Bryan shares his practice's philosophy, how new technologies have aided his practice in orthodontics and what he has done to better communicate with patients and other dental professionals.
Name: James D. Bryan, DDS, MS
Townie name: orthojb
Graduate from: University of California, San Francisco (UCSF) dental school
Year graduated: 1977
Practice Name: Bryan Orthodontics
Practice Location: Mission Viejo, CA
Year when this office opened: 2001
Practice Size: 1,400 square feet/five operatories
Staff: Six total staff (three chairside assistants, one office manager/financial coordinator, one treatment coordinator, one scheduling coordinator
Web site: www.bryanortho.com

Office Highlights
Bonding Agents
• 3M Unitek Transbond LR
• Add & Bond
• Ormco Orthosolo
• Reliance Porcelain Etch & Conditioner

Cements
• 3M Unitek Glass Ionomer

Impression Material
• Kromopan Alignate
• Splash impression putty and PVS

Click Here To View Dr. Bryan's Top 5		 Technology
• Apple Computers
• Damon System — brackets, wires, auxiliaries
• Invisalign
• OmniDROP, interoffice secure electronic delivery
• OrthoCad Digital Study Models
• Quick Ceph Studio
• TopsXtreme Practice Management
• VectorTAS Temporary Anchorage System
• Zap Laser
Why did you choose orthodontics as your career path?
I really liked the fact that orthodontics is a field that allows you to capture diverse interests in one specialty. When you look around at orthodontists in general, you find a common thread of entrepreneurship and innovation; most orthodontists are also involved in researching or developing new techniques in the field, or even new technologies outside of orthodontics. I've also noticed a lot of orthodontists who are marathoners, rock climbers, musicians — expressions of personalities that enjoy a challenge and the artistic side of things. As an undergraduate Biomedical Engineering major at UC San Diego, I appreciated the opportunity to utilize both my biology and my engineering backgrounds in one specialty.

In your current practice situation, what is a typical day's schedule? What kinds of cases are you doing routinely?
I think our typical day is probably the same for a lot of orthodontists with long appointments like starts, finishes, and mid-treatment repositionings in the morning and regular adjustment appointments in the afternoon. We use the Damon System for the vast majority of our cases, both child and adult. In the early years of the practice we started a significant number of clear bracket cases, but with the Damon System's improved aesthetics in their hybrid bracket and the benefits of their treatment mechanics, our adult patients are choosing Damon over clear brackets so often that I can't even remember the last time I put on a set of clear brackets. If our patients are truly interested in the clear look, most of them choose Invisalign. Since we are established in a family-oriented suburban community, a significant portion of our patient population includes early treatment cases.

Who are the people on your staff and in what capacity do they function?
While we work together as a cohesive whole, we have two distinct teams in our office, the front office team and the clinical team, and each team has its own unique personality that makes it successful. Our front office staff consists of our office manager/financial coordinator, our treatment coordinator, and our scheduling coordinator. All three of them are nurturers, problem solvers, and communicators, and all three take personal responsibility for making each patient visit enjoyable and the process seamless for the parents. My clinical teammates are thorough, systematic and committed to keeping both the daily schedule and the patient's treatment on time and up to my clinical standards. When I observe the team working together, it's clear that we have the right people in the right roles.
What is your biggest source of new patients? How do you market to new patients?
Like many growing practices, our greatest source of new patients is existing patient referrals. We work very hard to make every patient experience a great one — from greeting them by name, to updating them about treatment at every appointment, to ensuring that parents have regularly scheduled time to speak with the doctor. It's being aware of even the little things like providing the latest and most interesting magazines for busy moms to read in the waiting room. And we are sticklers for detail — if we say we're going to do something, we make sure it gets done right and right away.
Dr. Bryan and team, committed to communication.
Tell me about your practice. What do you do that sets you apart from other orthodontists in your area?
When I opened the practice in 2001 with no patients, brand new office construction and only my wife in the front and me treating patients, I was committed to excellence in communication and building personal relationships with our patients and colleagues in the area. Simply put, we wanted to be more than just an office — we wanted to create an office family. To that end, we have never overloaded our schedule by contracting with insurance plans and we have enhanced our communication systems as the practice grows to ensure that we never lose the fundamental integrity of what we set out to achieve.

What I've found is that even though we are just one small part of our patients' lives, we really are able to make a difference to their families. Not only are we able to change patients' smiles and give them confidence about the way they look and feel every day, but my team is also able to help busy parents navigate the ortho process, manage their hectic schedules and balance family priorities. We have an oral hygiene and elastics follow-up program to aid parents in motivating their kids to brush, floss and wear elastics to finish up treatment. We have a reliable recall system to make sure our patients are scheduling and making their appointments to keep treatment on time. We also have a follow-up system for any unusual requests or situations that arise to make sure nothing and no one falls through the cracks. One mom summed it up for us recently when she said, "When I come to your office it feels like I'm coming home." It's feedback like that that tells us what we're doing right, and what we never want to lose sight of, no matter how large the practice grows.

What systems have you implemented to improve communication with patients and parents?
It comes down to an attitude or mindset and staying committed to it as an entire team. My office manager reviews every patient on the schedule each day and informs our team of any issues we should be aware of. She also reviews all treatment notes at the end of the day to ensure follow up and identify any new concerns that need to be addressed or monitored. We make it a point to update the parent at every appointment and we make sure they get consistent face time with me. If parents are unavailable, we set up a phone conference with them or set aside special time for them at their child's next appointment to make sure nothing gets missed. We have written progress reports that we give to parents and send to the general dentist every six months. I am currently in the process of setting up an online visit summary so that parents and patients will be able to access their treatment updates, along with emergency information, elastics and appliance instructions, and other helpful tools on our Web site 24/7.
What are some of the problems you have found in communicating with other dental professionals?
Over the years, I've seen how essential it is to have good communication between professional colleagues and how difficult that can be to achieve. Every office has different technological systems as well as varying comfort levels of the staff and doctors using that technology. There are plenty of software solutions on the market, but they don't always work well together and there are too many barriers to adoption such as cost, learning curve, and lack of versatility.
Omnidrop.com: secure electronic delivery with built-in accountability.
What solutions have you implemented to solve this inter-office communication problem?
I envision a fundamentally different approach to address the communication dilemma that currently challenges the dental and medical industries. To solve this problem, I joined up with colleagues to create a universal software solution that is not another practice management system or imaging application, but rather a solution that complements dentists' existing systems, reaches out and engages their colleagues' existing systems, and can even work independent of these systems if a practice does not have its own practice management software. Our first product is OmniDROP, a HIPAA-compliant secure drop box for delivery of any file type with bidirectional messaging and work-flow assistance. It's simple yet powerful. Currently I use it for sending X-rays, photos, referral forms, letters, extraction requests and any other document that would be useful to a colleague. We are continuing to add functionality to it, but even in its simplest form I've quickly discovered that I wouldn't want to work without it. Not only is it useful with any current software, it's platform independent, meaning it will work on a Windows PC or a Mac.

Since you began your career as an orthodontist, what are the three biggest changes you've seen in the profession?
I think the three biggest changes I've seen in the last eight years have been the introduction of Invisalign and other clear aligner systems, the resurgence of self-ligating brackets and the emergence of digital orthodontics. The upside of Invisalign has been the aesthetically pleasing option we can offer to patients who otherwise might not have considered orthodontics; the downside has been the marked increase in general practitioners doing orthodontics in-house. Self-ligating brackets have been around for decades, but the developments in treatment mechanics and philosophy have really taken orthodontics to a different level. There are a lot of naysayers, but it looks like self-ligating brackets are here to stay.

The change that I find most interesting is the emergence of digital orthodontics and the possibilities for the industry that are just now being explored. Some examples that come to mind are 3D imaging including intraoral scanning, digital study models, Invisalign, robotic technology like SureSmile, digital setups, and indirect bracket placement systems such as Ormco's Insignia or OrthoCAD iQ. I believe there is a great deal of potential for digital orthodontics, but there is still a lot of work to be done. Adoption of these technologies is limited for a number of reasons including expense, learning curve and resistance to change by the orthodontist and staff, and lack of interoperability between systems. The last reason is both a technological problem and a communication problem — we simply must find a way for these technologies to work together.

What kinds of new technologies has your practice embraced? How have they improved your practice?
As a natural skeptic, I started slowly with the Damon System but soon realized the benefits of converting fully to the system and its treatment philosophy and I've been very pleased with that decision, both clinically and organizationally. The benefits I've seen are lighter forces, fewer appointments and great results. We have also already established the OmniDROP system between our office, several referring GPs and specialists, and our X-ray lab. We will soon be utilizing this drop box to communicate with patients and their parents. Visit summaries and other important documents will be securely delivered to this drop box to create a well-organized personal orthodontic record. The documents will have links to my Web site to give further information or instruction as it directly relates to the most recent appointment.

How has Orthotown benefited you and the way you practice?
With the hectic pace of a growing practice and a growing family of three very young kids at home, it's difficult for me to get to many professional events. Orthotown gives me the opportunity to network and consult with colleagues from the convenience of my office or home. I'm able to get advice, see how other orthodontists solve difficult problems, and find out what products they use. I've posted X-rays on the message boards and had oral surgery consults online. Some members are also really good about posting valuable orthodontic literature references, which helps immensely when I'm researching a specific issue. And sometimes it's just a great chance to get to know other orthodontists from all over the world who really understand where you're coming from and can laugh at and empathize about some of the challenges we all face.
Orthotown Magazine
September 2025
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