A Charitable Way to Charge for Replacement Retainers

Like many orthodontists, I normally include an initial retainer in the total treatment fee. If a patient loses or breaks a retainer, a replacement is provided at one-half the usual fee of $250 for a Hawley retainer and $150 for a thermoformed retainer. I have always regarded this as a fair charge for time and materials.

One day I received a phone call from a patient's mother, who informed me that her child had lost her retainer and that she was disappointed that she would be charged for a replacement. She did not understand why I should "profit from her misfortune" after she had already spent more than $4,000 on her daughter's treatment. She told me that she had two other children who would need braces in the future and that my policy made her consider switching to a different orthodontist. Needless to say, she got my attention. I agreed to waive the normal charge for a replacement retainer and said that we looked forward to treating her other children.

I then wondered how many other parents had decided to take their children elsewhere or declined to refer their friends to our practice as a result of our policy. I did not want to provide replacement retainers to everyone at no charge, nor did I want to drive away any potential business.

Every year, I contribute a significant amount of money to charities that are important to me. I thought, why not partner with my patients to give even more to these charities, while avoiding the appearance of profiting from my patients' misfortune?

My staff and I came up with what we call "Project Smile" (A). Any patient who loses or breaks a retainer is asked to write a check for the cost of a replacement retainer to one of five selected charities. The patient is given a receipt for tax purposes. Each month, I add up the contributions and match them with my own checks.

Patients and parents have found this a more acceptable way of paying for replacement retainers. The charities are appreciative, and our practice has received positive local publicity for the program.