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Office Visit: Art with Intent by Kyle Patton

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Office Visit: Art with Intent 

This Townie’s boutique practice offers touches of luxury, a unique whitening studio and a slow-paced approach where stress gets left at the door

by Kyle Patton, editor
photography by Izaiah Johnson

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.
As an associate, Dr. Erin Fraundorf routinely saw upwards of 150 patients a day. That high-volume churn often left her feeling disconnected from her patients. When she set out on her own, she did so with careful, intentional planning to create an entirely different experience—for herself and her patients. Her St. Louis, Missouri, office features luxury, style and technology at every turn, from massaging chairs, dimmable lights, and flat screens to clinical choices like charging for consultations and opening the only whitening studio in the city.

In our exclusive Q&A, she shares insights and advice on how orthodontists can plan and execute opening a new practice (or improve an existing office), the extra behind-the-scenes work she did to make her dream practice a reality and much more.

 
OFFICE HIGHLIGHTS
NAME:
Dr. Erin C. Fraundorf

GRADUATED FROM:
University of Louisville School of Dentistry; Saint Louis University— Orthodontics Residency (2018)

PRACTICE NAME:
BOCA Orthodontic + Whitening Studio
St. Louis, Missouri


PRACTICE SIZE:
2,999 square feet; 6 private patient suites + two-chair whitening studio, consultation room

TEAM SIZE:
3

You’ve leveraged your background in art to create a beautiful practice. What elements are you most proud of?

I love things that are unique and non-traditional. While I have great respect for other dental and orthodontic practices, I didn’t want BOCA to be a typical, cookie-cutter orthodontic office. “Traditional” has never been my style. So, when designing my studio, I drew inspiration from art galleries, luxury hotels and spas.

I wanted to create a concept, an experience, a feeling—something truly unique. I wanted to shake up the industry and carve out a brand that was as focused on the patient experience as it was on the patient’s smile. That’s why I designed BOCA as a smile sanctuary, where every detail is intentionally selected to reflect our core mantra: that smile care is self-care.

What I am most proud of is creating something entirely my own, even if it goes against the grain. Some specific design elements I really enjoy are the private patient suites named after specific artists, the calming monochromatic aesthetic, the sculptural curved walls, the lounge filled with lush greenery, the light oak benches with storage, the large quartz island in the clinical area and the dedicated whitening studio.


From a more practical standpoint, what were some learning experiences you could share for doctors thinking of opening a new office?

One of the most important lessons I have learned is that you can’t do everything yourself. While it might seem like a given, it took me a while to realize that learning to delegate is crucial—not just for the success of your business but also for preserving your sanity and relationships.

For doctors thinking about opening a new practice, managing your expectations is essential. When you first open your doors, it’s natural to hope for a flood of patients immediately, but that’s rarely the case with startups. Expect ups and downs, busy days and slow days. Patience with both your practice and yourself is key.

Additionally, it’s wise to have a significant source of income outside of your startup during the initial growth phase, which often spans a few years. This could come from a variety of sources, such as personal savings, a spouse’s income or working as an associate while you build your practice.

I am just past two years into my startup and still work three days a week as an associate outside of BOCA. While I would love to be in my studio every day, designing smiles in my little sanctuary, I am incredibly fortunate to have other jobs I love and from which I continue to learn and grow.
You’ve said that you “bet on yourself” in starting such a high-end boutique office. What was behind that bet?

I believe the primary indicator of readiness is motivation. If you’re truly motivated, you will move mountains to make your vision a reality and achieve success.

My motivation stemmed from a deep desire to offer more to my patients and to myself. My experiences creating smiles at other practices left me desiring more—more quality time with patients, more customization and a more experience-based approach to care. On a personal level, I wanted to practice more artistically and intentionally. These desires sparked the creation of BOCA and fueled my commitment to this significant endeavor.

Of course, starting a high-end boutique practice involves much more than motivation. Here are some key areas I focused on to ensure I was able to confidently embark on this venture:
  • Research and planning. I invested considerable time researching the market, understanding the area and pinpointing the needs and desires of my target demographic. This research allowed me to craft a detailed business plan.
  • Financial preparation. I thoroughly reviewed my financial status and planned for future financial needs, including startup costs, ongoing expenses and potential cash flow gaps. I ensured that my income from my associate job could cover costs if the startup took longer to gain traction.
  • Networking. I connected with local entrepreneurs, orthodontists who had recently opened practices and industry professionals to gain insights and advice. These relationships have been invaluable and continue to guide me.
  • Designing the brand and experience. I designed a brand and space that resonated with my target demographic and reflected my practice style. Collaborating with a graphic designer, architect and contractor helped ensure every detail enhanced the patient experience.
  • Personal development. I focused on improving myself in all of my roles in life. Developing leadership and management skills is imperative to running a business. Running a practice requires not only clinical expertise but also strong business acumen and effective team leadership. And while various continuing education courses may help, therapy is a game changer. I highly recommend it for anyone, especially those venturing into a startup.
  • Support system. Behind the scenes, I have a tremendous support system that has been crucial to my success. My parents instilled a strong work ethic and drive, while my partner, family and friends provide unwavering support. They are my sounding board, my stabilizing rock, my motivation to continually push for personal and professional growth.

You went with a non-traditional office model, slow-paced and focused on the details. What are some examples of this?

I wanted to create a boutique, concierge-style practice where I could focus on my patients with intention and care. My previous experiences involved seeing 100–150 patients a day, and while there’s nothing wrong with that model, it left me feeling disconnected. With the high volume, I found myself not knowing many of my patients’ names, which for me, felt impersonal.

I wanted to know my patients not just by their teeth, I wanted to know them as human beings.

At BOCA, we offer one-hour smile consultations and extensive one-on-one doctor time, which allows me to get to know each patient personally and provide meticulously customized care. This more concierge approach to care ensures in-depth patient education and maximizes our patients’ appointments and time. For example, if a patient breaks a bracket, we address it immediately rather than rescheduling. We also try to work around patients’ schedules as much as possible by offering before and after school/work appointments.

Having a slower-paced practice, I can focus on the smallest details, which I believe are often the most important.


Admittedly, you’re still learning the business side of the practice. What practice management changes have you made since you started and why?

One of the most impactful changes I have made is implementing a consultation fee. This has been a game changer for our practice. Given the extensive time we dedicate to each consultation, the fee ensures that patients have a stake in the process and are invested in us, as we are in them. While the fee isn’t exorbitant, it’s enough to discourage those who might be price shopping or not serious about committing. This approach has significantly increased our conversion and reduced our no-show, cancellation and reschedule rates, bringing them close to zero.

Another ongoing adjustment in my practice is expanding my delegation. I strive to delegate more intentionally and frequently to focus on the core aspects of my role. Admittedly, this is an area where I’m still growing, as I tend to be a bit of a control freak. However slow it may be, I’m making steady progress and learning to share responsibilities.


A lot of your marketing is accomplished through Instagram. What tips do you have to best leverage that platform?

My biggest piece of advice for social media is to be authentically you. You don’t need to share everything with the world, like what you had for breakfast, but share who you are—your personality, your interests, your vibe. Just like your website, prospective patients come to your social media to get a snapshot of you and your practice. Prospective patients are looking for a genuine glimpse into who you are and what your practice is like. Stock photos, generic posts from ad companies and inauthentic branding can be off-putting. When you stay true to yourself, it resonates with your audience and helps build a genuine connection.

Social media, especially Instagram, is an incredibly powerful yet often underutilized tool in orthodontics. It’s become as crucial as having a website, if not more so. For many patients, particularly those seeking orthodontic care, Instagram is now their go-to platform for finding and evaluating practices. It provides a way for patients to not only discover your practice but also get a sense of what to expect before they even step through the door.


Talk to us about your clear aligner philosophy.

Clear aligners are everything. They form the cornerstone of my practice philosophy. They are not just a treatment option. They’re a strategic asset that enhances smile transformation outcomes, patient satisfaction and practice efficiency. Even though the high lab fees can be daunting, especially for a startup, the benefits of incorporating clear aligners into your practice are substantial and undeniable.

Patients appreciate the ability to get their dream smile without the discomfort of traditional braces. Although orthodontics may not have true “emergencies,” incidents requiring immediate attention can be costly in terms of chair time, materials, staff involvement and patient dissatisfaction. For a startup, managing these emergencies is even more challenging when you’re not in the office full-time. Clear aligners significantly reduce the need for such urgent appointments and offer greater flexibility in scheduling. This makes them an invaluable tool for new practices, helping streamline operations and improve overall efficiency.


You’ve made whitening a focal point of your practice. What do you offer and how has it worked out so far?

Incorporating teeth whitening as a focal point has surpassed my expectations. Often, teeth whitening is perceived as an afterthought in orthodontics—something patients think about “after their braces come off,” typically involving just a syringe of whitening gel in their Essix retainers. However, I believe teeth whitening deserves far more attention and care.

To address this, I developed a signature teeth-whitening menu that features an array of in-studio and take-home options. During a teeth-whitening smile consultation, we delve into each patient’s whitening history, smile, smile goals, budget and lifestyle. This personalized approach allows us to customize a whitening plan that ensures we deliver optimal results in the most efficient and comfortable way possible.
TOP PRODUCTS
INVISALIGN
At least 95 percent of my orthodontic patients choose to utilize Invisalign clear aligners for their smile transformation. This treatment modality allows my patients to have a more comfortable experience, more flexible and less frequent appointments, more discrete treatment and no emergencies.

ITERO
With an iTero scanner, we are able to eliminate gooey impressions and ensure the highest accuracy and most efficient care. Integrating the latest technologies into daily practice is integral in obtaining the best results. Bonus, we greatly reduce waste and our carbon footprint by not using alginate, disposable impression trays and stone.

ORAL-B IO
An oral care ritual must. Aligned teeth are great, but not if they come at the cost of oral health. Excellent oral hygiene is imperative for my patients during treatment, so I provide every single orthodontic patient with the ultimate oral care tool.

FOREST DENTAL CHAIRS
Hydraulic powered with Ultraleather and soft-touch back massage. Comprising six private patient suites, BOCA was intentionally designed with the patient experience in mind to promote a sense of tranquility, comfort and luxury.

BRASSELER USA BURS
Contouring (a term I use to describe “enameloplasty”) is an extremely effective and impactful procedure (and one of my favorites). It allows us to buff out chips, smooth out undesired mamelons, blend wear facets, make teeth more symmetrical and give the smile balance. There are so many patients that come in stating they want veneers due to the shape and color of their teeth and leave ecstatic following their treatment with orthodontics, contouring and teeth whitening.

What’s your message to those who want to start a practice?

Be creative. Be bold. Be patient. Forge your own path and define your unique style of practice. Discover what resonates with you, what will set you apart and embrace it fully. Innovation and originality are the keys in creating a practice that stands out and fulfills your vision. Starting a new practice requires immense courage and resilience. Be prepared to face challenges and push through incredibly difficult moments. Your bravery in taking this leap will be a testament to your commitment and determination. Be ready to have your strength put to the test. Success doesn’t happen overnight. It won’t happen in a day, a month or even a year. Building a thriving practice takes time, effort and perseverance. Understand that growth will come in stages and stay committed to your goals even when progress seems slow. The journey is demanding but absolutely rewarding. Take the leap because it’s so worth it.


How do you handle consultations?

Given the frequency of no-shows and price shopping within orthodontics coupled with our time, expertise and operational expense, I believe that the industry’s norm of free consultations really undervalues our work and does the entire industry a disservice. Therefore, I charge for consultations. This encourages patients to be committed to the appointment and respect the service we provide.

My consultations are extremely in-depth, requiring significant doctor time and focusing heavily on patient education. This thorough approach allows me to understand each patient’s unique needs and goals right from the start, enabling me to customize their smile design to fit their specific lifestyle. For instance, I have had patients whose professions involve frequent public speaking on television. Without this insight, I wouldn’t have known to adjust their smile design and prescription accordingly.

During consultations, my patients sit in a comfortable, loungey non-clinical chair and I sit across from them in a conversational manner to encourage dialogue.

Intentionally, we are on the same level so they feel less of a barrier to opening up and feeling at ease. I use a large television screen to present multiple images, often drawing on the images to illustrate various clinical discussions. With the patient, I review their photographs, radiographs and Invisalign Smile Simulation. This projected smile transformation is incredibly impactful, helping patients clearly understand and visualize the anticipated end result.


How do you think schools could better prepare the next generation of orthodontists?

To better prepare the next generation of orthodontists, residencies should integrate more technology, business-centric content, interpersonal skill training and cosmetic exposure into their education. Emphasizing these areas will ensure that future orthodontists are well-prepared for the clinical, business and leadership challenges they will face.

Incorporating business in orthodontic education would be incredibly helpful too. Courses on business management, financial planning and marketing could aid in equipping future orthodontists with essential business skills.

More exposure to psychology and training in communication skills would be very beneficial as our career heavily relies on successful relationships with our patients and staff. Developing strong communication skills and teaching effective patient management techniques can improve our relationships with patients, and subsequently their compliance, happiness and overall treatment outcomes.

Students should be also exposed more frequently to cosmetic cases to best prepare them for practice outside of academics. Understanding how orthodontics fits into broader health and aesthetic contexts, particularly cosmetic cases, can improve the success of multidisciplinary cases.


What was your most humbling experience in the profession? Likewise, what has been your proudest moment so far?

The most humbling experience for me has undoubtedly been learning how to run a business. It’s been a huge challenge, as it’s not something that comes naturally to me, nor is it something I was formally taught. I have always excelled in the clinical aspects of orthodontics, so struggling in business management was a completely new realm.

I had minimal exposure to business and entrepreneurship, so diving into this world was like stepping into uncharted territory. However, this challenge has also been an incredible learning opportunity. Each setback and success has contributed to my growth as both a clinician and a business owner and it’s this journey that has made the accomplishments along the way all the more meaningful.

My proudest moment in the profession has been venturing out on my own and starting my practice. Creating something from scratch, without a safety net, in a town where offices being bought by corporations was becoming the norm, was both terrifying and incredibly rewarding.


Give us a snapshot of your life outside of practice.

I really feel like my practice is my life, and my life is my practice. The line between it and me as an individual is very blurry. While I know that my career doesn’t define me, I’ve structured it in a way that allows me to be myself both in and out of my white coat. So, if you see me at the gym or in carpool giving someone smile care advice, just go with it.

When I’m not in the office, you can find me enjoying time with family and friends, practicing yoga, spending time outdoors or listening to NPR. I love going on adventures with my little one, niece, and nephews and walking with my dogs, Finnegan and Duffy—BOCA’s “Chief Happiness Officers” who you might spot around the studio from time to time. I thoroughly enjoy a good date night with my partner and exploring plant-forward restaurants with him. Hanging out at local farmers’ markets is one of my favorite things, and while I love to travel, I don’t do it as often as I’d like, so I’m hopeful that I can make that a priority in the coming years.



Orthotown Magazine
September 2025
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