The Power of Pre-Gaming by Dr. Zachary Varble

Start Discussion
Categories: Orthodontics; Practice Management, HR and Accounting;
The Power of Pre-Gaming

How remote monitoring transforms workflow and efficiency in braces treatment

by Dr. Zachary Varble

Orthodontists evaluating remote monitoring often ask a straightforward question: Does this technology actually make a difference in day-to-day clinical practice?

Based on my experience, the answer is yes, but not necessarily for the reasons many people initially assume.

When remote monitoring is discussed, the conversation often focuses on reduced appointments or patient convenience. Those are certainly meaningful benefits. But the real impact emerges when remote monitoring is integrated into the operational systems of the practice.

The greatest value comes from preparation.


Start with workflow, not technology
One of the most common mistakes practices make when adopting new technology is treating it as a tool rather than a system.

Remote monitoring should not simply be layered onto existing workflows. Instead, it should be incorporated into how the practice prepares for patient care.

In our office, the most transformative change was implementing the pre-gaming process—reviewing scans and defining clinical plans the day before the appointment. That single adjustment allowed our clinic to move from reactive chairside decision-making to proactive planning. That shift also changes the orthodontist’s role during the appointment itself.

In a traditional workflow, the doctor’s chairside task is to evaluate the patient, decide on the next clinical step, and communicate that plan to the assistant. Pre-gaming moves most of that planning to the day before. During the appointment, the doctor’s role becomes verification rather than planning—a fundamentally faster cognitive task. Verifying that the planned treatment step was executed correctly requires less time and mental effort than making a new decision in real time. That distinction is one of the main drivers of improved clinic efficiency.

For orthodontists considering remote monitoring, the first step should not be asking how the technology works. The first step should be asking: How could this help us prepare better for our patients?
The Power of Pre-Gaming
Fig. 1: Remote monitoring allows orthodontists to plan appointments in advance, reducing chairside decision-making and improving clinic flow.


Use remote monitoring to improve visibility
Orthodontic treatment is continuous, but our observation of it has historically been periodic.

Traditional appointment intervals give orthodontists snapshots of treatment progress, but many small changes occur between visits. Remote monitoring fills that gap by providing visibility into treatment progression throughout the process.

This visibility can reveal patterns that might otherwise go unnoticed:
  • appliance issues
  • compliance challenges
  • hygiene concerns
  • unexpected tooth movement
Identifying these issues earlier allows orthodontists to intervene sooner and maintain consistent treatment progression.


Empower the clinical team
Remote monitoring also provides an opportunity to strengthen team efficiency.

When treatment plans are defined before the appointment, assistants can begin the visit with clear direction. Instead of waiting for the orthodontist to evaluate the patient and decide the next step, the team already understands the objective of the visit.

This clarity improves the pace of the clinic while allowing the orthodontist to focus on verification and oversight rather than real-time planning. Beyond efficiency, this shift has an important impact on the clinical team.

In the traditional workflow, assistants often operate in a stop-and-wait cycle: They seat the patient, wait for the orthodontist to evaluate progress, and then execute the treatment steps within a compressed window. Over the course of a busy clinic day, that pattern repeats dozens of times and can become a meaningful source of stress and burnout. Pre-gaming the clinic day removes that dynamic. When assistants begin an appointment already knowing the objective of the visit, they can work at a smoother, more predictable rhythm. The result is not only improved efficiency but also a more sustainable workflow for the team.

Practices that implement this approach often find that the technology not only improves monitoring, it also improves teamwork.


Maintain clinical oversight
Some orthodontists worry that remote monitoring might reduce doctor involvement in patient care.

In practice, the opposite tends to occur.

Remote monitoring does not replace clinical judgment. Instead, it enhances the orthodontist’s ability to evaluate treatment progression between visits.

When used effectively, the orthodontist maintains full responsibility for treatment planning while gaining additional information that supports better decision-making.

Another important benefit is the reduction of real-time cognitive load for the orthodontist. On a busy clinic day, a doctor may make 70 to 80 independent clinical decisions while moving rapidly between operatories. When those decisions are made chairside under time pressure, it becomes difficult to think as clearly as one would in a quieter setting. Pre-gaming moves many of those decisions to the day before, when the orthodontist can review scans and treatment progress without the immediate demands of a full clinic. Making those decisions in advance allows the doctor to approach the appointment with clarity and focus. Rather than seeing the patient only at scheduled appointments, the orthodontist now has ongoing insight into treatment progression.

Focus on incremental improvements
Adopting any new system can feel daunting, but the most successful implementations often begin with small adjustments.

For example:
  • reviewing scans before clinic days
  • defining treatment plans ahead of appointments
  • monitoring patient compliance patterns
  • adjusting scheduling based on clinical readiness
Each of these steps represents a small improvement. Over time, those improvements compound and lead to meaningful changes in efficiency and clinical control.
The Power of Pre-Gaming
Fig. 2: Pre-gaming the clinic day allows orthodontists to review treatment progress and define clinical actions before the appointment begins.


A new way to think about orthodontic care
Orthodontics has always been a profession that evolves with new technologies and ideas.

From innovations in bracket design to digital imaging and aligner therapy, each advancement has helped orthodontists deliver more precise and efficient care.

Remote monitoring represents another step in that evolution. It does not change the biological principles of orthodontics. Teeth still move according to the same biological mechanisms they always have.

What it changes is our ability to observe that movement.

By providing continuous visibility into treatment progression, remote monitoring allows orthodontists to manage care more proactively, prepare more effectively for appointments, and maintain consistent oversight of treatment outcomes.

For our practice, that shift has been transformative.

Orthodontic treatment still happens every day. Now we simply have the ability to see it.


Final thoughts
For orthodontists who treat primarily with braces, remote monitoring may initially seem like a technology designed for aligners. But the experience in our practice has shown that continuous monitoring can be equally valuable for fixed appliance treatment.

By improving preparation, strengthening team workflows, and providing greater visibility into treatment progression, DentalMonitoring has allowed us to operate with greater efficiency while maintaining high standards of clinical care.

In many ways, the change is subtle. The mechanics of orthodontic treatment remain the same. But the way we manage that treatment, and the way we prepare for our patients, has evolved.

And sometimes, a small shift in workflow can completely change the game. 
Author Bio
Dr. Zachary Varble Dr. Zachary Varble is a private-practice orthodontist and educator based in St. Louis. A St. Louis native, he earned his Doctor of Dental Medicine degree, magna cum laude, from Southern Illinois University School of Dental Medicine and completed his Master of Science in dentistry and certificate in orthodontics at Saint Louis University, graduating first in his residency class and receiving the J.P. Marshall Award. He maintains a full-time private practice while teaching practice management to orthodontic residents. Known for his practical, real-world approach, he lectures on Dental Monitoring and digital workflow integration, sharing systems developed in his own practice to improve efficiency, consistency, and patient care.


More In Orthodontics
3 Wire Treatment - An Efficiency Game
3 Wire Treatment - An Efficiency Game
Dr. Chad Foster
CE Credits: 1.5
A Voice in the Arena: RPE, Caplin Hooks and Nighttime Elastics
A Voice in the Arena: RPE, Caplin Hooks and Nighttime Elastics
by Dr. Chad Foster
June 2023
Expand Your Reality
Expand Your Reality
Dr. Michael K. DeLuke
CE Credits: 1.5
New Products
New Products
June 2023
More In Practice Management, HR and Accounting
From Underwater to Unstoppable
From Underwater to Unstoppable
by Dr. Jacquee Schieck
March 2026
Navigating the Dental Insurance Landscape: Optimizing Benefits Reimbursement
Navigating the Dental Insurance Landscape: Optimizing Benefits...
Dr. Dominique Fufidio
CE Credits: 1.75
Office Visit: Dr. Christopher Cetta
Office Visit: Dr. Christopher Cetta
by Kyle Patton, associate editor
May 2023
Real Estate: Real Issues for Starting (and Selling) a Dental Practice
Real Estate: Real Issues for Starting (and Selling) a Dental...
Charles Feitel
CE Credits: 1.5
Orthotown Magazine
March 2026
Orthotown Magazine March 2026 Read Current Issue Read Archived Issues
Sponsors
Related Articles
Taking the Pulse of Your Practice
Taking the Pulse of Your Practice
by Brittany Frazier
July/August 2023
The Human Touch
The Human Touch
by Dr. Susan Blair
September 2024
Understanding Oral Facial Habits
Understanding Oral Facial Habits
by Dr. Daniel J. Grob
September 2025
Site Menu
Message Boards Magazine Continuing Education Podcasts Pods & Blogs Classifieds News Events Townie® Poll Ebooks Townie Choice Awards
Company Info
Contact Us Advertise With Us Howard Farran DDS, MBA Policies and Agreements
Site Help
The Orthotown Team, Farran Media Support
Phone: +1-480-445-9710
Email: support@orthotown.com
©2026 Orthotown, a division of Farran Media • All Rights Reserved
9633 S. 48th Street Suite 200 • Phoenix, AZ 85044 • Phone:+1-480-598-0001 • Fax:+1-480-598-3450