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Office Visit: One in a Million by Chelsea Knorr, Associate Editor, Orthotown Magazine

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One in a Million
by Chelsea Knorr, Associate Editor, Orthotown Magazine

You could say that Dr. Marlene Ostby is one in a million - both figuratively and literally. She is the only female orthodontist in Montana, which just recently hit the one million mark in population. As for the figure of speech, her extensive education, specific knowledge of cleft palate and her chairside manner speak for themselves. Herein, she talks about what it's like to practice in the "Last Best Place" in America.

How and why did you get into orthodontics? At what point did you decide "this is what I want to do"?
Ostby: I always knew that I wanted to somehow make a difference in people's lives, and it was important to me to find a career that would allow me to balance my working life with being a mom. So, choosing to become an orthodontist was actually a calculated decision. My role model was my own Phase I orthodontist. She was a cheery, hard working, successful woman/mom who enhanced the self-esteem of her patients by creating beautiful smiles. This was the perfect scenario!

Name: Marlene Ostby, DDS, MS, Board Certified Orthodontist
Dental School Graduate From: Baylor College of Dentistry; 2003
Orthodontic School: University of Iowa; 2007
Practice Name: Ostby Orthodontics
Practice Location: Billings, Montana
Also in Practice: Dr. Buddy Kastrop
Dr. Adam Ostby
Web site: www.ostbyorthodontics.com

What is your practice philosophy?
Ostby: Do unto others, as you would have them do unto you! My priority is to educate people as well as I can about what orthodontic problems they have and if/how they would benefit from orthodontic treatment. I spend a considerable amount of time helping people understand the things they need to know to make informed decisions about their care. This is how I would want to be treated if the roles were reversed.

Tell me a little about your practice.
Ostby: We have two offices - both in Billings. Both of our offices are relatively simple office spaces. I think in Montana it is best to keep it simple! Both of our offices have four patient chairs and one exam/records room.

There are three orthodontists working in our practice: our senior partner, Dr. Buddy Kastrop; my husband, Dr. Adam; and me. We have six employees and two locations.

Adam and I each work at both offices, although I do spend more time at one location over the other. It works out well that we can easily see each other's patients when the need arises, since our techniques are so similar.

What is the competition like in your area of orthodontics right now?
Ostby: Practicing orthodontics in Montana is different than in many other places around the country. The population of the entire state just recently reached one million, so there isn't a huge patient base to draw from. The orthodontists who practice here often choose Montana because this is where we want to live and play, not because we expect to have a booming million-dollar practice. So it goes without saying that the more desirable areas in the state are fairly saturated with orthodontists who love to hunt, fish, ski, hike, camp, ride bikes, etc. when we're not at the office.

Billings, specifically, is one of the more competitive areas in the state, but the orthodontic community for the most part is friendly and supportive. We have a local study group of orthodontists who get together once a month to discuss cases. We don't meet during the summer months, though, when it's too hard to pin us all down!

Tell me about Montana. Are you really the only female orthodontist in the state?
Ostby: Montana is a beautiful state. It is known as the "Last Best Place," and once you've been here, you understand why. The quality of life here is exceptional if you enjoy a slower pace and plentiful outdoor activities. It's definitely not the place to be if you like everything that a big city has to offer. Billings is the largest city in the state and the population is just over 100,000!

Yes, I am the only female orthodontist practicing in Montana. This wasn't by design, but it just so happens to be true. It has become my claim to fame!

What makes your practice different than other orthodontic offices? What do you do to set yourself apart?
Ostby: Having a female doctor in our practice definitely sets us apart. For various reasons, some parents prefer that their kids see a female practitioner. I know some men are offended by this idea, but it's true that some people are just more comfortable in my (small!) hands. An added distinction is that my husband and I work together, and having a husband and wife team is certainly unique.

We're also proud of the fact that all three of our orthodontists are board certified. There isn't another orthodontic practice in Montana or any of the surrounding states with three boardcertified orthodontists.

Who is your primary clientele? How do you get the word out about services to patients?
Ostby: We see a healthy mix of young patients, adolescents and adults in our practice.

Our practice has historically relied mostly on word-of-mouth referrals. Dr. Kastrop is very well respected within the Billings community and has treated multiple generations' worth of patients without having to do any advertising. Adam and I are lucky to have our names associated with his.

Since Adam and I are relatively new to Billings, we are getting involved in various ways to meet people and to give back to the community. In doing so, we are getting the word out about who we are and what we are about, and hopefully over time we will earn the same level of respect that Dr. Kastrop has achieved.

What is your favorite procedure or part of orthodontics?
Ostby: Seeing a smile transform throughout treatment is obviously gratifying, but I think what I like even better is developing relationships with the patients over the course of their treatment. Even the super shy younger kids open up by the end, and I like to have fun with them! I'm barely five feet tall, and I can't tell you how many kids have asked me to kick off my heels so we can compare our heights back-to-back. When they're that comfortable with you, you know you've fully gained their trust.

What challenges do you face in working each day?
Ostby: We always try to diminish our challenges! Right now we're working on reducing (eliminating?!) our bond failures. We recently tweaked our indirect bonding protocol, and it seems to be helping. Now if only we could figure out how brackets break while a patient is sleeping, we'd be set!
Who are some of your mentors?
Ostby: Most of my mentors come from my time at the University of Iowa. I was lucky to learn from both Drs. John Casko and Samir Bishara, a couple of our profession's giants. In addition, I can't say enough good things about the adjunct faculty members. Drs. Stark, Loucks, Hermanson and Hanneman each influenced me in ways that they don't even know. If you guys are reading this, thank you!

What do you find in terms of technology has the biggest "wow" factor for your patients?
Ostby: This might sound relatively mundane, but patients and their parents love getting e-mail and text message appointment reminders. It's such a simple concept, but we're constantly getting positive feedback about it. I worried at first that patients would think e-mails and text messages were less personal than a phone call, but no one has cared about that at all. So many people manage their schedules on their smartphones and computers nowadays, making it super convenient to communicate this way.

Describe your most successful or rewarding experience. How about a disappointing experience or failure?
Ostby: I was the chief orthodontist on the cleft lip and palate team at the University of Iowa for a couple of years after completing my residency. These were truly some of the most appreciative families I have encountered in my practice, so it was extremely gratifying to be able to make a difference in the lives of those patients. I have continued my involvement with cleft kids in Montana, participating in various cleft lip and palate teams around the state.

On the flip side, I always feel somewhat defeated on debond day if a patient has white spot lesions. I work really hard at hygiene with my patients, but I always wonder if I could have done something more to prevent them.

Looking ahead, what would you like to see orthodontics do in terms of the way it operates as a profession in the next five to 10 years?
Ostby: I would like to see us maintain a strong focus on educating the public about the benefits of orthodontic treatment, by an orthodontist. To be able to fully justify that position, we need to foster the highest standards throughout the profession. This means, among other things, that orthodontic residencies should continue to have the strictest admission criteria, especially as the number or residency programs increase. There should also be an increased emphasis on board certification. Orthodontists, as a collective group, can demonstrate a strong commitment to the specialty by becoming board certified, and this would give us an even greater distinction from non-orthodontists who offer orthodontic treatment. The general public just doesn't know that there is a difference, and it is our responsibility to educate them about it!

What is your favorite feature of Orthotown?
Ostby: I really enjoy reading through the case discussions. It's interesting to read how different orthodontists would approach the same treatment situation. I learn a lot from these threads!

What do you like to do when you are not working? What do you balance work with?
Ostby: I'm a new mom, so my non-work hours are consumed with diaper changes, feedings and nap schedules right now! Beyond that, I enjoy exercising and taking advantage of all of the wonderful outdoor activities that are so abundant in Montana.

Orthotown Magazine
September 2025
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