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Office Visit: Cosse & Silmon Orthodontics by Arselia Gales, assistant editor

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Categories: Practice Management, HR and Accounting;
Office Visit Cosse & Silmon Orthodontics 

by Arselia Gales, assistant editor
photography by Ivy B. French

Orthodontists spend most of their working hours inside their own practices, so they usually don’t get many opportunities to see what it’s like inside another doctor’s office. Orthotown’s recurring Office Visit profile offers a chance for Townies to meet their peers, hear their stories and get a sense of how they practice.
Drs. Jeffrey Silmon (at left in photo above) and Christopher Cosse have practiced together for almost two decades. In those 16 years, the two have mastered the art of practicing with a partner and managing four separate practices in the Shreveport/Bossier City area of Louisiana. While the pair didn’t initially start out together—Silmon worked as an associate in New Orleans before Hurricane Katrina in 2005—they’re a testament to the saying “Two heads are better than one.” Together, the two have created Braces Academy and OrthoScreening, online software programs designed to enhance patient education and virtual consultations.

In this month’s Office Visit, we take a tour of one of Cosse & Silmon Orthodontics’ four offices and see why these Townies and long-time friends enjoy working together. We also discover some of the unique ways they market their practice, learn about one of their favorite cases and more.
Office Highlights

Name:
Cosse & Silmon Orthodontics
Shreveport, Bossier City, Minden and Stonewall, Louisiana

Graduated from:
 • Dr. Christopher Cosse: Louisiana State University (dental school) and Oregon Health Science (orthodontic residency)
• Dr. Jeff Silmon: Louisiana State University (dental school and orthodontic residency)

Practice size:
Office #1: 5,000 square feet
Office #2: 3,000 square feet
Offices #3 and #4: 1,200 square feet each

Staff size:
30

You had similar journeys into orthodontics. How did you decide that orthodontics was the right profession for you?

JS: We both wanted to be cardiologists. We worked as EKG techs through college and decided that the medical field was not for us. We had good experiences in dentistry growing up. Chris’ dad was an orthodontist, so he was exposed to the pros and the cons of the orthodontic field. I just had a good experience and enjoyed both dentistry and orthodontics.

Dr. Silmon, you were working in New Orleans, but after Hurricane Katrina you had to start over. How did you connect with Dr. Cosse and eventually join his practice?

JS: I was only out of school for a few months before Hurricane Katrina hit Louisiana. I was working as an associate with one of my professors from orthodontic residency. After Katrina hit, many of my professor’s practice locations were under water or too damaged to use. My family and I decided to move back home to North Louisiana. I started working with Chris and his dad soon after. Chris and I had a great working relationship, and we decided to stay in Shreveport and eventually became partners.

 Now you’ve been in practice together for 16 years—what are some of the benefits of working with a partner? To what do you owe your success over the years?

CC: Working with a partner is great. We love bouncing ideas and treatment plans off each other. He’s a lot smarter than I am, so I get most of the benefit of those conversations!

JS: People ask us all of the time about our success working together. I think the key is that neither of us is too proud to be wrong or to learn from the other. We are open to constructive criticism and respectful debates. We continually want to learn and get better and it doesn’t matter where the idea comes from.

How do you manage your time evenly across the four practices? How far away are they from one another?

JS: We rotate to all of the offices and so does our team. We practice together one or two times per week to calibrate and discuss complex cases or cases that we want to see together. Our furthest locations are about an hour from each other, and our closest are 20 minutes away.

How do you divvy up the responsibilities among the two of you?

CC: That’s the easiest part of our partnership. We both lean toward certain aspects of the practice where we have the most interest: Jeff is a nuts-and-bolts guy and I’m more of the “What can we do that’s fun and unique?” type. We joke that our practices would look so much different if we practiced separately. We have a pretty good balance. We both know what our strengths and weaknesses are and we trust each other’s judgment.

You have a pretty unique marketing story involving car magnets that gives your practice a lot of visibility in the community. How did you come up with that?

CC: We were inspired by the decals you see on some cars whose owners have traveled to fun destinations—those white ovals with codes like “JH” for Jackson Hole, Wyoming. We made “CSO” ones for Cosse & Silmon Orthodontics, and then later went around town and picked random cars that had CSO magnets on them. The owners won a gift certificate and were entered into a drawing for free orthodontic treatment. The decals became very popular and we decided that it would be fun if we had them in different colors, fonts and logos, all under the CSO brand. It’s been a huge hit and a lot of fun.

What are some of your favorite cases to work on?
JS: Certainly the challenging cases are fun and rewarding. I think my favorite cases are the ones where treatment will make a huge difference in a patient’s day-to-day life. Helping someone feel more confident is extremely rewarding.

What is one of your favorite patient stories? Do you ever work on cases together or ask one another for advice?

JS: We treated a set of identical newborn twins who had mirror-image clefts. We took impressions with a custom impression tray when they were less than a day old; we had to go to the nursery at the hospital to do it, and used a nasoalveolar molding appliance. Their parents would come in every Friday and we would adjust the appliance with a slight modification to reapproximate the alveolar bones—think aligner therapy, but for moving bones, not teeth. There was a wire with an acrylic ball extending from the appliance to the collapsed nostril on the cleft side. The parents were superstars and had to keep the appliance taped in place and cleaned every day. That was a fun case and a great result.

How important do you think patient education is in your practice?
CC: We feel strongly about the importance of quality, easily accessible and easily referenced patient education. We felt like that was lacking in the orthodontic field, so we started creating videos. Next thing we knew, we had created Braces Academy, a prescriptive patient education software for orthodontics used all over the world. So that’s kind of a fun fact!
Top Products

Braces Academy Patient Education. We felt this was such a needed product that we created it from scratch. It helps us with efficiency and makes us look like a high-quality, high-tech practice.

Damon braces system. It has been around for decades and just keeps getting better. We can depend on it in our office.

OrthoScreening virtual consultation software. This has allowed us to capture new patients and make our practice more efficient. This allows for the best ROI in our practice.

i-Cat FLX (Kavo) has been amazing. Being able to see the airway and roots in 3D is a game-changer.

Gaidge practice management software is a must-have. We love being able to glance at our numbers and know exactly where our practice is and what areas we need to focus on.

Dr. Cosse, you’ve developed and created software to help orthodontic offices educate and communicate with their patients, and you also hold 20 orthodontic patents. That includes your own bracket?

CC: We developed OrthoScreening as a virtual consultation system a couple of years before the pandemic hit. It was primarily created to bring in new patients who were too busy to come into the office or didn’t have access to care.

Then, once COVID-19 disrupted orthodontists’ ability to see patients, virtual visits became a necessity and that product blew up overnight. Many orthodontists had a dilemma and didn’t know if patients would still be paying, so they didn’t want to add the expense of virtual consultation software. We ended up offering it at a significantly reduced rate to help everyone out. It turned out to be a good business move and a good give-back program. Most offices that signed up during that time are still using OrthoScreening.

My orthodontic bracket is still in development. It’s a little ahead of its time. Manufacturing hasn’t gotten cheap enough to make it cost-effective—that’s the biggest holdup at this point. I’m still excited about it, because manufacturing is constantly getting better and less expensive.

How would you like to see orthodontics evolve in the next decade?

JS: I’d like to see the field move away from direct-to-consumer treatment. I think we all know where that leads. I definitely want to lay eyes on my patients and make sure treatment is going as planned.

You both are Damon Premier providers and educators, and the only two orthodontists in Louisiana with this distinction. Do you feel this gives you an upper hand in your practice?

CC: Being Damon Premier providers and educators is a lot of work. The program is designed to have orthodontists from around the world who want to learn the Damon system and see it being used practice-wide. We enjoy this distinction, but we definitely learn lots from our visitors. That’s what gives us an upper hand.

 You’re both involved in an international group called “The Insiders” that meets twice a year.

CC: The Insiders is a great group of people—every one of them has a passion for improving orthodontics at every level. It was started by a group of Ormco doctors probably 40 years ago, and we were honored to be invited to the group 15 years ago. (Fun fact: My dad was an Insider 30 years ago, too.)

What do you like to do outside of the office?

JS: Chris and I are both family guys, so any break we get, we try to spend it with our families. We have lots of meetings and conferences we attend to continually learn new things, so we try to be present with the family as much as possible. And I’m a foodie, so much of that time is spent cooking and eating.
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