Building the Brand Before the Bricks by Dr. Ashley Kisling

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Categories: Office Design; Orthodontics;
Building the Brand Before the Bricks   

Designing a startup orthodontic practice with intention

by Dr. Ashley Kisling

Starting an orthodontic practice from the ground up is equal parts exhilarating and terrifying. Long before the first wall goes up, you’re making decisions that will shape your culture, patient experience, and profitability for decades.

This article walks you through the real process—what I did right, what I would change, and the intentional decisions that shaped the build-out of SOCO Pediatric Dentistry & Orthodontics. My goal is to take you from the first Pinterest board to the final operatory chair and help you avoid some expensive mistakes along the way.


Phase 1: Before you sign a lease—study, tour, and listen
The startup journey begins long before getting the keys to your space. Looking back on my journey, I would have done more due diligence. I would visit as many offices as I could, from new startups, 30-year legacy practices, high-volume Medicaid offices, and boutique fee-for-service practices.

I would ask colleagues blunt questions: What did you overspend on? What would you never do again? What do you regret not making larger? What slows down your clinical flow?

Based on the conversations I’ve had and how I feel in my space after four years, the consistent themes are clear: Everyone wishes they had more storage and administrative space is almost always too small.

Simultaneously, I started a Pinterest board. Not a “dental office” board, but a vibe board. Spas in Mexico. Beach homes. Retail spaces. Luxury medical spas. I asked myself: “What does this office feel like?” Because patients don’t remember square footage. They remember how your office made them feel.


Phase 2: Designing for the Instagram generation
We live in a social media economy. Whether you like it or not, your office is a marketing asset. Before we ever broke ground, I asked: What is our Instagram wall? Where will patients take selfies? What visual feature will make them tag us?

For us, that meant surf-shack coastal warmth, playful but elevated design, and intentional photo moments. We designed mirrors with branded sayings. We added layered textures. We leaned into black beams overhead, inspired by a spa I fell in love with in Mexico. We created visual depth.

I did not want Disneyland. Even though we are pediatric and orthodontic, I did not want primary colors, cartoon overload, or theme-park chaos. I wanted warmth. Comfort. A space that felt like a home near the beach. When you design for longevity, trends matter, but timelessness matters more.


Phase 3: The architect—translating vision into flow
I hired architect Niall Saunders, and we met in person several times. This wasn’t a “send drawings over email” relationship. We sat down with plans and walked through every square foot.

We designed: a window-facing wellness layout to enhance a hospitality feel; hanging wood details from the ceiling, because when a patient is in the chair, the ceiling becomes their entire visual field; rear-facing operatories to eliminate visual clutter; and clean sightlines from consult to treatment that feel residential, not clinical.

We did not use an interior designer. Why? Because I already knew exactly what I wanted. My dad works in commercial real estate, so I had a comfort level with build-outs and finishes. I had curated inspiration for months. Every light fixture, tile, and beam had a reference image. But let me be clear: If you do not have a clear design vision, hire an interior designer. Architects think in structure and flow. Designers think in texture, tone, and cohesion. If you don’t naturally think that way, outsourcing that role will save you from missteps.


Phase 4: Interviewing contractors—value engineering
Once the plans were complete, we interviewed multiple contractors. Here is the phrase you’re looking for: value engineering. Value engineering is when a contractor reviews architectural plans and identifies where costs can be reduced without compromising structural integrity or core design. This process is critical. One contractor may say, “This is the price.” Another may say, “If we reframe this wall, substitute this finish, and modify this detail, we can cut $200,000.” That is how we chose our contractor, CMM Construction. They didn’t just price our plans. They improved them. They took what I envisioned and found creative, budget-conscious alternatives that kept the aesthetic intact. They shaved hundreds of thousands off the projected cost, bringing the project within my financial comfort zone.

If you are interviewing contractors, ask for itemized budgets, ask what they would change to save money, ask what typically goes over budget, and call at least three references.

This decision will affect your financial runway more than any chair choice ever will.


Phase 5: Hand-built, not plug-and-play
We did not do plug-and-play cabinetry. Everything was custom-built.

Why? Because I didn’t want the office to scream “dental.” I did not want bulky side cabinets hugging chairs. I wanted rear-facing operatories. I wanted clean lines. I wanted the space to feel residential. The black beams were inspired by a spa in Mexico I had visited years before. The open ceilings added volume and warmth. The lighting was layered, with no harsh overhead lighting.

When it came to our artwork, I went through thousands of images on Getty Images, specifically filtering for those available for free download. I spent hours searching for photographs that aligned with our surf-inspired, coastal, terra-cotta warmth. Once I selected the images, I had them professionally printed at a local print shop, then took them to a local framing store. We custom-framed each piece to match our aesthetic. It was more work than clicking “add to cart,” but the result was layered and intentional. The artwork doesn’t scream “dental office.” It feels like something you’d see in a boutique hotel or a thoughtfully designed home.

All of our seating was built by our contractor. Then I went to a local upholstery shop and went through—quite literally—thousands of swatches to find a fabric that matched our terra-cotta branding exactly. The upholstery vendor built all of our bench cushions custom and recovered a couch I found on Amazon with the exact color of the cushions.

For the wallpaper, I scoured the internet for something that aligned with our brand. After weeks of searching, I found the perfect one. It pulled everything together, and it ended up being from West Elm. But here is a tip: Order more wallpaper than you think you need. I did not and now it is discontinued. If we ever have damage or need a repair, matching it will be impossible. In a commercial environment—especially a pediatric one—walls take a beating. Plan for the future, not just opening day.

During our build-out, COVID-19 hit. Suddenly, we were all rethinking airflow, spacing, and barriers between chairs. I wanted something between the chairs but I refused to sacrifice the openness of our open bay. The solution was custom commercial storefront glass partitions. These were not temporary dividers. CMM custom-built them. They functioned as cleanable barriers, but because they were framed like architectural glass storefront systems, they elevated the space rather than making it feel divided. Originally, I assumed we would remove them post-COVID. But we never have.


Phase 6: Mistakes and regrets
No build-out is perfect. Here’s what I would change:

Storage, storage, storage: We built bench seating in the open bay with hidden storage, which helped. But you will accumulate more supplies than you think. Holiday decor. Marketing materials. Swag. Lab cases. Extra scanners. You can never have too much storage.

The open bay parent dilemma: The built-in benches in our open bay are beautiful. But they invite parents and siblings back into treatment. If I redesigned today, I would create a larger, hospitality-style waiting and play area designed so parents want to stay there.

Administrative space: This is my biggest regret. If I could redesign, I would make the administrative space significantly larger. I would shrink the check-in/welcome desk and model it after the Apple Store—one greeter up front with all phones, while insurance, billing, and operational chaos would happen behind closed doors.


Phase 7: Designing for growth
When you build, think five years ahead.

Ask yourself: Will I add another associate? Where will their desk and office be? Will I add more chairs? Will I bring another specialty in-house? Every wall is expensive to move later. Think expansion before you pour concrete.


Financial and emotional reality
A startup build-out will stretch you emotionally and financially. There will be days you second-guess every decision. There will be change orders, delays, and supply chain surprises. But your physical space is not just a place to practice. It is a recruiting tool. It is a marketing engine. The office you build will shape the type of team you attract and the type of patients who walk through your doors.


Final advice to the future startup doctor
  1. Visit at least 10 offices before designing your own.
  2. Start a Pinterest board immediately.
  3. Define your Instagram feature wall early.
  4. Hire an architect who understands dental flow.
  5. Value engineer your plans.
  6. Overbuild storage.
  7. Make administrative space bigger than you think.
  8. Design with emotion, not just efficiency.
If you’re building your first practice, remember this: You’re not just constructing operatories. You’re building a brand. You’re building a culture. You’re building a space where families will trust you with their children. And if you do it intentionally from every beam, every bench, every chair, you won’t just open an office. You’ll open something unforgettable. 
Author Bio
Dr. Ashley Kisling Dr. Ashley Kisling is a board-certified orthodontist and the owner of SOCO Pediatric Dentistry and Orthodontics in Southern California. Kisling earned a bachelor’s degree in public health sciences at UC Irvine in 2011 and a DDS from UCLA in 2015, then completed her three-year orthodontic residency program in Georgia.




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