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Office Visit: Orthodontics in the Round Benjamin Lund, Editor, Orthotown Magazine

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by Benjamin Lund, Editor, Orthotown Magazine

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

This month, we visited Dr. Bob Waugh at his practice, Waugh & Allen Orthodontics in Athens, Georgia.
Name: Dr. Bob Waugh
Graduate from: Medical College of Georgia (MCG) School
of Dentistry; Baylor College of Dentistry Orthodontic
Residency Program
Year graduated: 1987 (MCG), 1989 (Baylor)
Practice Name: Waugh & Allen Orthodontics
Practice Location: Athens, Georgia
Year when this office opened: September 2008

Office Highlights
Bonding Agents
• Ortho Solo from Ormco
• Reliance Liquid Etch
• Transbond LR and XT adhesive
• Transbond self etching primer
• Ultradent Etch Gel

Brackets/Wires
• Damon 3MX (Ormco)
• Orthos Molar Tubes (Ormco)
• Phase I American Buccal Tubes

Cements
• Ketac Glass Ionomer


Click Here To View Dr. Waugh's Top 3

Class II Correction Appliances
• Crowned Herbst Appliance

Class III Correction Appliances
• Full Tx Vector TAS (Ormco)
• Phase I Reverse Pull Headgear

Impression Material
• Kromopan Algi

Patient Financing
• In office no-interest payment plans
• Outside financing with Chase HealthAdvance
(in the process of adding CareCredit)
• Pay-in-full discounts
When you use the terms "precision" and "efficiency" in the orthodontic specialty, they often refer to the exact placing of brackets or the minute intricacies of moving teeth ever so slightly within the mouth of each patient so that the desired results are achieved in the shortest amount of time. But at Dr. Bob Waugh's practice, Waugh & Allen Orthodontics in Athens, Georgia, "precision" and "efficiency" take on whole new meanings.

When his partner, Dr. Bill Allen retired, Dr. Waugh inherited about 1,000 patients and was presented with a unique challenge — how was he going to oversee all of them? Waugh wanted to be able to direct every treatment plan, but with multiple satellite practices, it proved to be difficult. Scheduling for the multiple offices was becoming nearly impossible and the installation of digital X-rays in each of the practices was extremely cost prohibitive. Out of necessity, Waugh and his team met this challenge head on and consolidated three of his Athens-area practices into a single, massive 24-chair, 8,400 square-foot facility designed by Atlanta Design Associates (Gary Lowery, Andea Smith and Karen Schwank) and built by Merit Construction with some help from local project consultant Dr. Rick Waters. The newly designed facility features top-of-the-line technology and a one-of-a-kind, never-before-seen practice layout that allows Waugh and his associates to easily see up to 120 patients a day.

Waugh's affinity for orthodontics began when he was 13 years old and receiving his own treatment from orthodontist — and later, mentor — Dr. Jerry Capps. Waugh always liked technology, gadgets and inventions, and partly because his father owned his own business, Waugh was instilled with his own entrepreneurial identity and longed to own his own business some day. "When I was 13, I wanted to be an orthodontist for all the wrong reasons, be they Jaguars or women," says Waugh. "[Orthodontics] is a lot of work but it's like a hobby to me. I'm kind of like a frustrated architect in a way — engineering with an artistic touch." Waugh has practiced orthodontics for about 20 years and has overseen a lot of different projects, but nothing like the consolidation of his practices.

"I wanted to get treatment back under one person's direction — my own. I wanted to direct all of the treatments and with three satellite practices, I couldn't be everywhere all at the same time," says Waugh. "We created one mega office where we could treat all these people." The new practice, which takes up a majority of the first floor of The Exchange building in Athens, opened in September 2008, and has essentially rocked the perception of how an orthodontic office can work.

The Wheel
If you've ever waited in line for one of those immense gotta-try-it-at-least-once-while-we're-still-here theme rides at Walt Disney World, you know how it goes: At the beginning of the line you hang out in the turnstiles for a few minutes, then they send your group through to a stage where some animatronic cartoon character preps you for the ride you're about to take, then more turnstiles, then maybe another stage that further explains or intensifies the ride's storyline, then more turnstiles, then they buckle you in and you're off. For a patient at Waugh & Allen, the experience is kind of like that, except there are no turnstiles and no screaming.

Patients are admitted to the minute at Waugh & Allen. When they arrive, and if they're on time, patients receive a medical pager that will go off when they're ready to be seen. In the meantime, patients can hang out in the reception area, or spend some time in the practice's interactive area that was designed by local Apple Store "PeachMac" owner Darryl Peck. When the pagers go off, patients are admitted in groups of four to six. Rather than a Disney character prepping them for their experience, the patients view a short video explaining the next steps. The patients are then allowed through the gate and enter "the wheel" — a circular room built in the middle of the practice, which is primarily used for hygiene and group diagnostics, orchestrated by Dr. Waugh in the center of it all.

It's in the wheel where patients are evaluated by Dr. Waugh and hygienists, receive a (Dentsply) Prophy-Jet cleaning and have pictures taken to document progress. Parents are encouraged to join the patients for this part of the office visit and communicate directly with Dr. Waugh regarding their care. The staff handles more questions later during patients' 30-minute adjustment outside the wheel. A patient's chair time in the wheel lasts 15 minutes before he or she is sent through to another area of the practice like the clinical area or, if necessary, the emergency area.

Waugh & Allen is a Damon practice, according to Waugh. The practice uses the Damon System and the new facility was totally designed around it. All of the decisions are made in real time and on a read-and-react basis – hence, the necessity of the wheel where patients are quickly evaluated and prepped before they graduate to their next station.

As orthodontists, you know all too well that hygiene compliance in orthodontic patients can be hit or miss, depending on the patient. It can be heartbreaking for some who find out they need several fillings on their newly straightened teeth because they didn't floss or brush enough. That's why hygiene is a foremost concern at Waugh & Allen and three dental hygienists are employed to administer the Prophy-Jet cleaning to patients in the wheel to avoid decalcification around brackets. "Most ortho patients get only two cleanings a year when they visit their dentist," says Waugh. "We place a high value on hygiene in our practice, and we make sure our patients get four cleanings each year."

Another primary necessity for the development of the wheel is that it is a perfect area to be able to take photos, documenting the progression of each patient. "It's nice to go back and revisit the photos," says Waugh. "A picture is worth a thousand words, and with that we're getting good clinical feedback and great patient compliance."

After 15 minutes in the wheel, where the patients' teeth are cleaned, evaluated, and photos have been taken (and barring any emergencies), that group of patents is sent into the clinical area, and the next set of patients enters like clockwork. Arrival and departure clocks keep everything moving smoothly. In fact, since Waugh's new office opened, every single patient who has been treated has been admitted precisely on time. That's the way this wheel keeps turning — 15 minutes per wheel session, 20 sessions per day.

Patient Punctuality and Emergencies
With so many patients to oversee and the high volume of appointments it schedules on a day-to-day basis, Waugh & Allen must run a very tight ship. Patients who arrive late or show up to their regular treatment appointments with an emergency (e.g.: broken brackets) will be seen, but they won't receive a Prophy-Jet cleaning or photos, and sometimes, their regular appointment is deferred to another time. If Dr. Waugh's patients value being seen, they'll value being on time for every appointment.

There's really no excuse for Waugh & Allen patients who have an emergency to wait until their regular treatment appointments to get them fixed. "We don't deal with broken brackets at scheduled appointments anymore," says Waugh. "We have a dedicated emergency staff in the office and we offer our emergency patients same-day seating. Two of our chairs are for emergencies only." Waugh explains that brackets that come off need to be tended to immediately, as they can be deleterious to the progression of orthodontic treatment if left un-bonded for too long. "I don't want my patients to wait to come in for a regular appointment if a bracket comes off. Broken brackets extend treatment," says Waugh. So to fight that, any time a patient has an emergency, he or she can call during business hours and set up a same-day appointment to get it taken care of straight away.

The practice also boasts its own 3D diagnostic center — with its own separate entrance and reception area, no less — and uses the imaging technologies of the i-CAT from Imaging Sciences International, Inc.; the PracticeWorks 9000C 3D; and an ultrafast, 3D surface photographic imaging device from 3dMD. This area of the practice employs a full-time radiologic technician who expertly manipulates the digital images to present patient views from just about any perspective and is able to merge the 3D photos with CT scans. All of the practice's CT scans are sent and reviewed by an off-site radiologist who has, in the past, discovered other things that were not ortho related.

Education
Teaching has always been a passion for Dr. Waugh. Upon graduating from Baylor's orthodontic program in 1989, Waugh has been teaching orthodontics curriculum at the Medical College of Georgia (MCG) School of Dentistry — primarily because the school wanted to learn more new ortho techniques. "I'm selfish; I teach because it forces me to learn. It's good medicine," says Waugh. "Once a month, I go down to MCG and work through cases with residents not only to help them in their training, but also to strengthen mine."

Education has become such a strength for Dr. Waugh that Waugh & Allen is becoming a teaching center for ortho, opening its own courses right there at the new practice.

"This new facility turns into a really incredible classroom," says Waugh. "The problem with a lot of group trainings is that there's one focal area and you have to move the attendees around so they can get a glimpse of what's going on in the subject's mouth. During in-office courses, we've got a 42-inch TV in front of every two chairs at the practice. We're all wired up so that whatever the camera on the instructor's loupes sees, the attendees see as well. So when the instructor is bonding a case, they'll see exactly what he's doing with the live patient."

As you can see, Dr. Waugh's new office facilitates personal patient care on a massive scale, while allowing him to oversee all treatment plans and it is his patients' one-stop-shop for emergencies and imaging. The office's recent foray into offering education is only the first glimpse into the amazing potential this space can offer. There are endless opportunities on the horizon for Waugh & Allen, which suits Dr. Waugh just fine.
Orthotown Magazine
September 2025
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