Office Visit: Dr. Todd Wesslen by Kyle Patton, associate editor

Office Visit: Tech Savvy 

This Townie’s background in computer science turned out to be surprisingly compatible with a career in orthodontics

by Kyle Patton, associate editor
photography by Cary Edmondson

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.

Every year, Orthotown asks readers to vote for their favorite products and services, then tallies the results and publishes the full list of Townie Choice Awards winners in our January/February issue. (Check out this year’s roundup here.) Out of all the readers who completed their ballots, we draw one person at random to win a special prize: $1,000 and the chance to appear on the cover of Orthotown magazine as part of an Office Visit profile.

This year’s winner, Dr. Todd Wesslen, began his professional career in the computer science industry, but the jobs had him wishing for more person-to-person interaction. Now 10 years into practice and with two offices in California’s San Joaquin Valley to his name, Wesslen continues to combine his first love—technology—with his passion for orthodontics. He recently remodeled both of his practices with a keen eye on delivering digitally driven results without sacrificing the human element needed in patient care.

In this month’s Office Visit, we learn how Wesslen leverages a computer-science mindset in the realm of orthodontics, which pieces of tech keep him on the bleeding edge, what he learned from remodeling two offices, and more.

Office Highlights
Dr. Todd Wesslen

Graduated from:
Loma Linda University School of Orthodontics and Dentofacial Orthopedics

Practice name:
Wesslen Orthodontics,
Tulare and Visalia, California  

Practice size:
Tulare: 2,000 square feet, 6 operatories
Visalia: 1,450 square feet, 5 operatories

Team size:
1 doctor, 6 clinical assistants, 3 front office staff
You took an interesting route to orthodontics. What was your path?
During the internet hype of the late 1990s, I decided to major in computer science in college and ultimately wound up with a master’s degree while doing software development for multiple years. I love technology and I love problem-solving, but eventually I wanted a change for two key reasons: First, I wanted more meaningful human interaction, and second, I wanted to run my own business.

Although they seem very different, I find that programming and orthodontic treatment both require some degree of abstract thought—for example, imagining how you want a treatment plan or software project to come together over time.

I enjoy the physics involved in orthodontics and, not surprisingly, I also love all the cool technology we use every day. I gained exposure to the field of dentistry through my wife, who’s a dental hygienist, my father-in-law, a periodontist, and my brother-in-law, a general dentist.

I can confidently say I have achieved a great deal of meaningful human interaction in my career as an orthodontist. I have great satisfaction in producing confidence in my patients, and I enjoy having the freedom to run my practice the way I want.

Tell us about your practice, its history and what your day-to-day is like.
I bought an existing, well-established practice immediately after I graduated from my orthodontic residency at Loma Linda University. I felt extremely well prepared for the clinical challenges that come into our office each day. The existing practice was a two-office, one-orthodontist practice with time spent equally in both offices. I have kept things very similar thus far, working essentially every other week in each office.

Coming from a computer science and software development background, it’s no surprise that you’ve embraced tech in your practice. What elements of your practice most reflect this?
Probably the biggest theme is that I’m not afraid to adopt new technology and, in turn, train my staff on it. Immediately after purchasing the practice, we transitioned into a 100% paperless system. We’ve had 3D printing in our office for years. We learned how to make aligners in the office for limited cases. The staff is trained in how to work with CBCT and STL files. Everyone seems to enjoy seeing how different technologies fit into the orthodontic practice.

You’ve been a beta tester for some practice management software companies. What are some tips or advice for other doctors who might be underutilizing, or perhaps unaware of, some features or capabilities?
Just because you’ve always done something a certain way doesn’t mean there’s not another, better way to consider. Paper forms? Get rid of them. Go to digital HIPAA-compliant forms and never look back. Phone call or email reminders? Consider doing SMS reminders. Are you sending out paper statements? Email them. Or even better, get all your patients on an auto-pay plan.

Which cases excite you most?
I like surgical cases a lot. Severe Class III or Class II cases with strong buy-in for surgery are great. I find a lot of satisfaction with complex impacted tooth cases, although sometimes it’s hard to be patient and sometimes these cases are not successful.  

You recently had both of your offices remodeled. How did you go about it? What would you do differently next time?
In general, it went very smoothly. We sourced a local contractor and designer with whom we had worked previously. It was convenient to have two locations that aren’t too far apart—in each remodel, we simply shifted our patients to the opposite office. Both projects were completed in around 14 weeks.

If I had to do it over again, I might consider building out a new space for our smaller office instead of remodeling. While efficient, we do have some space bottlenecks. But now, after remodeling both offices, I’m not sure I would have the energy to build out a new space at this point!

The pandemic brought about some changes that have stuck around. How do you think patient monitoring can or will improve?
I’m not sure remote monitoring necessarily will improve COVID-19 challenges themselves, but I suppose for the cases I am remotely monitoring, if there were a health-related reason a patient couldn’t visit the office, we would have in place a great mechanism to monitor treatment.

Remote monitoring does not prevent all visits to the office, however! Until an accurate scan of teeth can be taken with a smartphone, patients still have to come in for scans. And they still have to come in for interproximal reduction, attachment failures and progress radiographs.

But had most of our aligner patients been remotely monitored during the COVID-19 shutdown, I wouldn’t have stressed quite so much about how my patients were doing.

Walk us through your management style.
I like to be involved in most areas of our practice, but as we have grown, it has been necessary to delegate some administrative duties I’ve done for years. I used to do all my treatment coordination and office management, but I’ve slowly let this go so I could focus more on treatment planning and patient care. I like to highly train my assistants and involve them in helping me evaluate new products or technologies.

My clinical assistants are awesome and always rise to whatever clinical challenge we have. My front office takes care of many things—from patient intake to insurance billing to social media ideas, scheduling, paying bills, etc.—so I can focus on patient care. They really can do it all! I find if I work alongside my team and we all work together, we are at our happiest and most efficient.

Top Products
iTero digital scanner. Being able to quickly take a digital impression to be used for Invisalign, study models or multiple different appliance fabrication options, including metal appliances, is a game-changer.

Tops Ortho practice management software. This software has been rock-solid for our two-office practice. Data is hosted offsite. All patient information is accessible anywhere we are. Active development of new and timely features combined with a receptive, available support team is fantastic.

I-Cat 3D imaging system. I am a better orthodontist because I can visualize, treatment-plan and design in 3D. Overlaying roots with iTero to get accurate root positioning from the start of treatment is remarkable.

Rhinogram patient communication platform. Allows us to text our patients efficiently and in a HIPAA-compliant manner.

DentalMonitoring remote monitoring platform. Allows us to keep a closer eye on the progress of cases than ever before. In some cases, we can eliminate the need for patients to come into the office as often.

Now that the remodels are over, what aspects of the offices are you most proud of?
I think I’m most proud of the fact that we finally brought our offices up to date in many areas. Previously, we had some inexpensive bedside cabinetry for our chairside delivery units. While functional, it was subpar.

We have 3D printers, CBCT imaging and iTero scanning available in both offices. We designed the office with a little bit of a bicycle theme because I enjoy cycling—we sourced an artist who does vintage posters of places all over California and now feature some of his work that includes bicycles.

As part of the remodel, we removed an existing darkroom, rerouted traffic to and from the restroom, and plumbed the sixth chair for overflow or semiprivate treatment. Additionally, the sterilization bay was enlarged and improved with cabinetry provided by Boyd Industries. Chairside delivery units are also from Boyd and feature self-contained water supplies.

Tell us about your second location.
Our Visalia location is a historic home (100+ years old) that had first been renovated into a dental office. A couple of decades ago, it was converted into an orthodontic office. It is small—about 1,500 square feet—but efficient, features Craftsman styling and large oak trees (common to our area) and is near downtown. We love the Craftsman style and get compliments on it daily.

The only difficulty: We share our exam room with our i-Cat machine, which makes it a little cramped. We remodeled this office first and completed it just in time to shut down for COVID-19. Although it was a huge bummer to not be working in a new space, I was able to complete a lot of little finishing tasks during the shutdown.

What are some underrated products and services other docs might want to look into?
  • Do your homework. (Podcasts were great for me.)
  • Formlabs printer. Great for study models and direct fabrication of splints, night guards and, if needed, limited aligner cases.
  • Blenderfordental software. A powerful set of dental plug-ins that work in the open-source Blender 3D modeling software. It’s useful to trim and base models, adding pontics for vacuumformed retainers, designing and creating splints, digitally articulating, etc. I’m looking forward to where this software goes because it’s a powerful, relatively inexpensive alternative to bigger commercial products.
  • PostDicom cloud solution software. Store CBCT data offsite, have multiple offices pushing data sets to a single cloud location for access from anywhere—shareable to other doctors, etc.

What’s a trend in the profession you love? What’s one you dislike?
I love that remote monitoring is finally usable, and I expect that technology will continue to improve. I don’t like the trend of DIY orthodontics. I have regular exams with patients who experimented with DIY aligners and didn’t get what they were looking for.

You’re into bicycling. Tell us about your bikes and your favorite rides.
Although historically I have ridden road bicycles primarily, in the past five or six years I’ve enjoyed feeling like a kid again and have immersed myself in mountain biking.

I now ride a Niner RIP, a Santa Cruz Chameleon and a Cannondale Supersix Evo. I enjoy annual trips to Moab, Utah, with my brother (who enjoys time out of his wheelchair riding a handcycle and is involved in adaptive sports) and my 12-year-old son, Henry.

I love the memory of completing the 10,000-plus-foot climb to Haleakala on Maui, Hawaii. The Tahoe Trail 100k mountain bike race (Leadville qualifier) was perhaps one of the most physically demanding rides I’ve ever done. Our family loves resort mountain biking at Mammoth and Northstar, and we enjoy taking bikes wherever we travel and searching for the best trails and routes.

During the wintertime, you’ll find me on Zwift, trying to check off virtual achievements.

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