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Office Visit: From Rocky Mountains to Clear Skies by Kyle Patton

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Office Visit: From Rocky Mountains to Clear Skies 

This Colorado Townie’s arduous entrance into practice ownership included taking over two offices at once, in military towns where patient and employee turnover came with the territory

by Kyle Patton, managing editor
photography by Jimena Peck

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.
Dr. Michael Kofford oversees four thriving practices in southern Colorado. His journey started 15 years ago with an impromptu challenge of launching two offices simultaneously— an experience that hammered home the importance of adaptability and mentorship. From navigating contracts and purchasing agreements to implementing technology and mitigating diverse patient demographics, Kofford’s experiences offer valuable insights.

In our exclusive Q&A, Kofford—pictured at right with associate Dr. Andrea Font—shares the lessons learned in launching multiple practices, mentorship, navigating contracts, bringing select technology in-house and much more.

 
OFFICE HIGHLIGHTS
NAME:
Dr. Michael Kofford

GRADUATED FROM:
Case Western Reserve University Dental School and University of Colorado orthodontic residency

PRACTICE NAME:
SoCo Smiles Orthodontics

PRACTICE SIZE:
3,450 square feet; 6 chairs

TEAM SIZE:
11
Of your four offices, you started two simultaneously—and a bit stressfully. What did you learn from that experience?

I graduated in November 2010, which was still a time of recovery for many orthodontists from the effects of the recession. When I finished my residency, there were only three practices that I knew of for sale in Colorado, where my wife and I wanted to live. One of these practices was near Fort Carson, where we had lived for three years during my time as a dentist in the U.S. Army.

It seemed like an ideal situation: I would replace an outgoing partner and become a 50/50 partner with a talented and skilled orthodontist, Dr. Lou Taloumis, who had built a successful practice.

We had been in contact for most of my last year of residency but as residency came to a close, I still didn’t have a contract. I was optimistic, so we moved to Colorado Springs, fully expecting to close the deal within weeks of my graduation. But after the move, it became clear the senior doctor no longer wanted to retire. I found myself, during Thanksgiving, without a job and with no clear path forward.

Around this time, an orthodontist in Pueblo who’d been dealing with cancer had tried to close his small practice: His disability insurance was ending in December, and 12 patients still needed to finish their treatment. None of them owed any money, but he offered me the chance to rent his building and finish their care in exchange for using his office to start my own practice. Although I was grateful for the opportunity, I worried this wouldn’t be enough to help me cover my student loans.

Then, a couple of weeks later, the orthodontist who had initially decided not to retire had a change of heart, and we closed on the practice in January 2011. I was fortunate to have this partnership with Taloumis, which allowed me to learn so much about treating patients and managing a practice while simultaneously building my own satellite practice from scratch.

This experience taught me a critical lesson: It’s always better to learn from others than to try to figure everything out on your own. Partnerships, mentorships and collaborative relationships are invaluable in the early stages of your career. You gain knowledge and insight that would take years to learn if you were working in isolation.


What’s your advice for approaching purchasing agreements or navigating contracts?

Looking back, the biggest lesson I learned was the importance of having a solid contract in place early in the process. I was too trusting and too reliant on verbal agreements, which left me vulnerable when the situation changed unexpectedly.

If I could go back, I’d ensure all agreements were put in writing and clear expectations were set from the beginning. A well-drafted contract provides protection for both parties and can help avoid misunderstandings or last-minute changes that can derail plans. It’s also a good idea to involve a lawyer to make sure the agreement is sound and your interests are fully protected.


Tell us about the surrounding community and your practice.

We work with a diverse patient base. One of our Colorado Springs offices is close to The Broadmoor hotel and Fort Carson, so there we treat a mix of affluent families from the Broadmoor/ Cheyenne Mountain area, as well as military families stationed at Fort Carson. Our north Colorado Springs office, meanwhile, treats a larger number of families from the nearby Air Force Academy and Peterson Space Force Base. In our Cañon City and Pueblo offices, the patients are typically families from more rural backgrounds.

I love working with all these different communities. It keeps our work interesting and it reminds us that orthodontic care is for everyone. I want everyone to have a smile they can be proud of. Every patient, regardless of their background, deserves the same level of care and attention.

One of the biggest challenges we face working in military towns is dealing with patient transfers. Military families often relocate before treatment is complete, so we’ve had to become flexible and proficient with different bracket systems to ensure continuity of care.

I’ve also employed many military spouses over the years, and while they are some of the best employees I’ve ever had, they’re usually with us for only two to three years before they move on. This constant turnover can make it difficult to maintain team chemistry, but it also gives us the opportunity to work with some incredibly talented and dedicated people who sometimes become friends.


What’s your advice for docs who want to move lab work in-house?

When I first started practicing, my mentor and partner made most of his appliances over lunch breaks, and I followed his lead. However, as technology advanced, so did my approach. My brother is a prosthodontist, and we co-own a dental lab in North Carolina. We began by sending scans to the lab for 3D-printed models, but eventually, I decided to bring a digital workflow directly into the office.

We purchased two Envision One printers to handle 3D printing for models, retainers and in-house aligners. Bringing this workflow in-house revolutionized our practice, but it wasn’t without its challenges.

One of the most important lessons we learned as a team was the necessity of having strong systems in place—scheduling systems, lab tracking systems and quality control measures. These systems are essential for ensuring everything runs smoothly and we maintain the highest level of care for our patients.

Implementing in-house lab work taught me that even small changes in a practice can have ripple effects. What seems like a straightforward adjustment can end up requiring changes to scheduling, staffing or even patient communication. Involving the team in the decision-making process and allowing them to help design these systems is crucial. Your team can offer valuable insights and help identify potential pitfalls you might not have considered.


What are the three most important things doctors should consider before they attempt an expansion?
  1. Solid systems. Before you think about expanding, make sure your current practice has solid systems in place. If your original office isn’t running smoothly, those problems will only be magnified as you try to scale.
  2. Leveraging your team. Think carefully about how you’ll leverage your existing team to support your expansion. Will you need to hire additional staff? Can some current employees split their time between locations? Your team is the backbone of your practice and their support is critical to the success of any new office.
  3. Impact on quality of care. Expansion should never come at the cost of the quality of care you provide to your existing patients. Make sure you aren’t spreading yourself too thin and you can maintain high standards across all locations.

As a mentor for the AEGD program, what can you tell us about general dentists and their opinions of orthodontics?

There can be a sense of separation between dental fields. Many general dentists understand the importance of orthodontic care but don’t grasp the complexities involved in treating a patient with orthodontic therapy. As a mentor, I’ve worked to bridge that gap by fostering better communication and collaboration between general dentists and orthodontists.

General dentists are often the first medical professionals patients see, and they play a crucial role in identifying when orthodontic treatment is necessary. The more general dentists understand about orthodontics, the better they can advise their patients.
TOP PRODUCTS
ITERO ELEMENT AND ITERO ELEMENT PLUS
3D scanners have made a huge impact on our practice. I’m a big Invisalign provider, so the iTero is a must. The digital lab submissions are also so nice using EasyRx.

INBRACE LINGUAL BRACES
InBrace patients are some of our happiest patients. Being able to straighten teeth with nothing showing is nice for our adult patients, but we also have a surprising number of teenagers in InBrace. Having a 3D printer and lab makes a huge impact being able to avoid some digital enhancement (refinements).

ENVISION ONE D PRINTERS
Being able to print models in-house for retainers, surgical models, inhouse aligners using uLab and other appliances has been a great benefit to me and my patients.

ART WIRES (now from American Orthodontics)
Simple and I love using them. There are just times when I want to change the torque to the front teeth. I use an MBT .022 prescription, so no custom torque prescriptions like some doctors. ART wires help me avoid adding torque to the wire.

INVISALIGN
So many patients tend to ask for treatment with Invisalign.



Which features in your office are you especially proud of?

Our practice is designed to provide comfortable care for our patients while fostering open communication with their families. Although we have an open bay layout, each treatment chair is separated by cabinets, which gives patients a sense of privacy without cutting them off from the relaxed, communal atmosphere we aim to create.

I love the built-in benches at the foot of each chair. We encourage parents to come back during their child’s appointments, and it’s not uncommon to have a parent with a couple of kids sitting on the bench, watching the treatment and engaging in conversation. This setup facilitates better communication between the patient, parent and orthodontist: It’s easy to discuss treatment progress, compliance or any concerns when everyone is present.

Another unique aspect of our office is that I often bring my toy poodle, who happens to have no teeth, into the practice. She’s become something of a mascot, and many patients know her by name. Her presence leads to natural conversations about the importance of teeth, oral health and the way teeth provide facial structure. Her friendly demeanor also helps put anxious patients at ease. The atmosphere is welcoming and a little more personal because of her, and it’s amazing how much of a difference that can make to both kids and adults.


Which lessons seem most obvious to you after 15 years in practice?

One of the most valuable lessons I’ve learned is the importance of mentorship. I would advise anyone entering the profession today to seek out as many mentors as possible. There’s so much wisdom to be gained from other orthodontists, and with the abundance of online forums like Orthotown, study groups and professional organizations like OSOs, there are plenty of opportunities to connect with more experienced colleagues. Learning from others’ successes and mistakes can help fast-track your own development.

Continuing education is another critical piece of advice. Early in my career, while still a dentist, I earned my FAGD award in just three years because I believed so strongly in the value of expanding my knowledge.

Attending orthodontic meetings and continuing education courses not only helps you stay on top of the latest advancements in the field, but it also provides you with a network of peers who can offer support and advice.


What was your most recent major investment?

Bringing 3D printing into the office five years ago. While it has been a significant change for our practice, the transition was more difficult than I anticipated. Changing our systems and adapting our scheduling to accommodate the new workflow took longer than expected, and the training required for the new technology was also more intensive than I had planned.

One issue we encountered was that a couple of our clinical chairside assistants wanted to move to the lab, thinking it would be cool to work with the 3D printer or that it would offer more schedule flexibility. However, after several months, we realized that some of these assistants were better suited for clinical work, and the absence of their skills in the clinic was putting a strain on the rest of the team. What was fun and exciting in the beginning becomes tedious and boring after a while.

This experience taught me a valuable lesson: It’s important to make sure the right people are in the right roles, regardless of their preferences. We need to consider the overall impact on the practice and ensure that everyone is contributing in the way that best suits their talents.

Looking forward, our next major investment will be in remote monitoring for clear aligner patients. After our experience with losing valuable chairside assistants to the lab, I’m much more conscientious about how we will implement the staffing resources needed to support this new technology. Change is exciting, but it requires careful planning and execution to be successful.


What mistake turned out to be the best teachable moment?

Realizing that trying to make too many changes at once can backfire. I’m someone who likes to stay on the cutting edge of technology and efficiency, but I’ve learned that introducing multiple new systems simultaneously can create more confusion than progress. Change needs to be managed carefully, with plenty of training and time for adaptation. Otherwise, you risk overwhelming your team and causing unnecessary stress.


What professional hill are you willing to die on?

I’m a firm believer in the importance of specialization within orthodontics. As more general dentists offer aligner treatments, it’s crucial for patients to understand the difference between an orthodontic specialist and a dentist who provides orthodontic care.

I want to be clear that I’m not disparaging general dentists who provide orthodontic care: Many of them are fantastic and refer patients to me because they understand the complexities of orthodontics. However, what appears to be a straightforward case can sometimes require advanced techniques and skills that not all general dentists have.

We as orthodontists undergo years of specialized training to understand how to manipulate the movement of teeth within the context of a patient’s overall facial structure and long-term dental health. It’s not just about making teeth look straight; it’s about ensuring proper function and stability. Patients deserve to know the qualifications of the person providing their care, and I think our profession should do more to educate the public on the value of seeing a specialist.


What’s your favorite patient story?

One patient who comes to mind is a 70-year-old woman whose sister paid for her to get braces. She had always wanted to straighten her teeth, but life got in the way. Watching her excitement throughout the process was incredibly rewarding. Every time she came in, she was so enthusiastic about her progress, and it was heartwarming to see how much her new smile meant to her.


How did you find your way into orthodontics?

Our family dentist told my parents he thought he could handle my orthodontic treatment. I had a congenitally missing lateral incisor, and after 3½ years of treatment, my teeth still didn’t look quite right. My parents began to wonder why the treatment wasn’t complete.

Our family dentist eventually told us I ‘d need an orthodontist to finish the work. That first appointment changed my life. I remember being fascinated when he showed me a tracing of my skull. The level of care and precision this orthodontist brought was a stark contrast to what I had experienced before, and it was in that moment I realized this was what I wanted to do for a living.

I also admired the orthodontist’s lifestyle. He had a two-hour lunch break, which he used to play basketball with friends and colleagues. As a basketball player, I thought, “That’s the life for me!”


Give us a snapshot of your life outside of orthodontics.

I love Colorado for its beauty, climate, people and endless outdoor activities—it’s the perfect place for me. I started my office in Cañon City to enjoy fly-fishing after work, a “ready, fire, aim” decision I’ve never regretted. I also have a home in Breckenridge, where we hike in the summer and ski in the winter. In the warmer months, I wake-surf as much as I can. Now that my wife and I are empty nesters, we’re exploring new hobbies, like swing dancing and joining a mixed doubles pickleball league.

Orthotown Magazine
September 2025
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