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The Future Is Now: How Millennials, Tech, and a Chess-Playing Computer Are Changing Orthodontics

This column is compiled by JCO Contributing Editor Robert S. Haeger, DDS, MS. Every few months, Dr. Haeger presents a successful approach or strategy for a particular aspect of practice management. Your suggestions for future topics or authors are welcome.

It has been stated many times that to successfully market an orthodontic practice, you have to target and appeal to the “35- to 45-year-old mothers.” Do you ever wonder what goes on in their decision-making processes or in their spheres of influence? Well, the authors of this Management & Marketing article do an excellent job analyzing the use of technology and social media by Millennials (both male and female) to answer these questions.

After reading (and re-reading) this article, you will have a much better understanding of the space Millennials operate in, which platforms to target, and what information is important to them, as well as the relevance of staying current with technology to market your office. Exceeding expectations is a vital step toward creating ardent fans (and likes) for a thriving practice. Without question, we will all benefit by applying the knowledge gleaned from this excellent article and sharpening our skills with Facebook,* Instagram,* Google,** and the like.


The Future Is Now: How Millennials, Tech, and a Chess-Playing Computer Are Changing Orthodontics

Maggie is a 28-year-old who spends her time writing for a variety of blogs and online media. Her husband is in the military and is stationed in Texas, far from their families in Missouri where they both grew up. Fortunately, she can keep in touch with her parents, siblings, and hometown friends through social media.

After she had her first baby, Maggie immediately opened an Instagram account dedicated solely to her new daughter, sharing the everyday routines and quirks of parenthood for all to see. The account is in her daughter’s name, establishing an online presence for the little girl even before she smiles for her first selfie.

Maggie is no outlier in her generation. A study conducted by Gerber.com found that 40% of Millennial moms create social media accounts for their children before their first birthdays.1 While that may seem odd to those from earlier generations, Millennial parents are simply more comfortable sharing personal information, especially online. And it’s not just moms. Millennial dads are also prolific sharers, and the men of this generation are becoming decision-makers for their children in ways that dads haven’t been in the past.

There can be no doubt that Millennial parents are creating a powerful voice online. Marketers are rapidly inventing new ways for them to share information, empowering them to do so in every area of their lives. This poses a unique challenge for orthodontists. Marketing to Millennials on social media and the Internet may not come naturally. What’s more, doctors must continue to communicate in the ways Millennials find most comfortable, including mobile phone apps and texting, once they become patients. Today, orthodontists can tap into the power of technology by using software enabled by artificial intelligence (AI) to involve patients in the process and give them a sense of control over their own treatment decisions.

Millennials are not only sharing on the web, but they are making purchase decisions based on recommendations from friends on social media and reviews posted on sites like Google and Yelp.*** If you are not managing your practice’s social presence and online reputation, you will be invisible to the Millennial consumer. This generation’s consumers are spread thin in terms of time commitment: they depend on virtual interactions such as depositing checks through a mobile app, ordering groceries through Amazon’s Alexa, or resolving billing issues on a virtual chat bot. To connect with them, you need to be technology-enabled and interactive in the way you run your practice and in your marketing.

Who Is a Millennial?

Although the specific demographics vary depending on the source, the Pew Research Center website describes Millennials as the generation born between 1981 and 1997. The site also found that Millennials make up more than a third of the U.S. population and are fast becoming parents. Millennial women accounted for 82% of American births in 2015.2 Many of those born in the early to mid-’80s now have treatment-age children.

We’re used to hearing about the power of baby boomers in economics, fashion, and culture. Now, the Millennials are taking over, bypassing the generations in between. In 2015, the U.S. Census Bureau reported that Millennials surpassed baby boomers as the largest generation in the country, with an estimated 83.1 million people compared to 75.4 million baby boomers.3

The people of this large and vocal generation are becoming parents and homeowners at a furious pace. This is a highly mobile generation that is comfortable with technology and wants to share their experiences online. Seldom tethered to desks, they prefer to integrate technology into their everyday lives, staying connected at work and play.

So Easy, a Library Can Do It!

Here’s a bit of good news: libraries aren’t dead. Of all the beloved institutions and inventions that are falling by the wayside in favor of technological innovations (think about the last time you developed a roll of film), libraries are actually thriving in the Millennial era. The Pew Research Center found that 53% of Millennials had used a public library within the previous 12 months, compared to 45% of Generation Xers and 43% of baby boomers.4 Does this mean a Millennial is more willing to crack open a book than an e-reader? Probably not. Rather, libraries have adapted to new technologies, offering a local place for people to gather, take classes, use free WiFi, rent Blu-ray movies, and yes, borrow e-books to download onto Kindles or iPads by reserving them on apps. In other words, libraries have kept pace with the times. Yet they still have aisles packed with physical books because they haven’t lost sight of their true mission: offering free content to the community. Millennials are attracted to a service that might otherwise seem archaic in the era of Wikipedia and streaming video because the library is meeting them on their terms.

This is how the orthodontic profession must approach our changing times. Millennials are the new decision-makers, and their influence is growing. The cultural gap between Millennials and baby boomers and Gen Xers keeps getting wider. Practices must provide a clear benefit to Millennials in their own space and on their own networks, offering an experience as well as a service. As with libraries, the core mission of orthodontists hasn’t changed. We still make people’s lives healthier and more enjoyable by straightening teeth, fixing overbites, and creating beautiful smiles. Communicating this as a value to Millennials and providing them with our service in the form and manner that they want—that’s a different story altogether.

Strengthen Relationships with Software

Most orthodontists currently communicate with their patients during regularly scheduled appointments. In between, there is the occasional appointment reminder call or e-mail, or possibly a greeting card during the holidays. The connection between patient and orthodontist is severed for weeks at a time and then punctuated by all-too-brief chairtime. Those few minutes may include a story about school, some dental advice, and then a quick adjustment, and the patient is off again. Such brief interactions easily become lost in the current climate of continuous communication.

While the orthodontist virtually disappears between appointments, other orthodontic-related messages now appear. Do-it-yourself (DIY) videos have sparked an entire online industry for YouTube** stars who teach viewers how to do everything from abstract art to zen meditation. If there is something to fix, there’s probably a website or video out there that shows you how to do it. This online revolution has even extended to tooth straightening. A search for “DIY braces” produces an endless supply of dangerous YouTube videos with questionable advice on how to straighten teeth cheaply at home. Reinforcing the idea that DIY orthodontic treatment is somehow safe, direct-to-consumer companies are selling aligners to patients without even requiring examinations. Millennials are a DIY generation, relying on technology to solve their problems. Orthodontists looking to pull Millennials into their practices and away from direct-to-consumer companies need first to differentiate themselves and then to effectively communicate their value.

This is all possible with new technologies. As an example, Dental Monitoring†† uses AI to minimize the number of in-person visits while promoting patient check-ins between visits, so that the orthodontist can make sure treatment is going as planned and spot small problems before they become big ones. To use this program, patients download an app onto their smartphones and use it to take pictures of their teeth. The uploaded images are immediately analyzed by the software’s predictive algorithm, and the resulting data are displayed through graphs, photos, and imaging. The doctor evaluates treatment in real time and gives instant feedback through the app.

This program scratches that itch for the instant communication experienced by Millennials on social networks like Facebook and Snapchat.‡‡ It’s akin to social media for orthodontists. Clinical diagnosis can be carried out in real time over WiFi from anywhere in the world, providing instant feedback. An orthodontist who sees a broken bracket or inappropriate tooth movement uses the Dental Monitoring software to alert the patient via the app, thus benefitting both patient and doctor by saving treatment time. Technology like this resonates with Millennials because it results in fewer appointments and shorter treatment times. It also allows orthodontists to continue monitoring patients who go off to college or are deployed overseas in the military. Moreover, smartphone technology can save time for both doctors and parents when it comes to starting treatment. How many times have you brought back a child on recall because you were waiting for teeth to erupt? On one hand, you know it will be years before the patient is ready. On the other hand, you want to check in every six months so you don’t lose the case. Parents view these “look-see” visits as a waste of their time. Monitoring by smartphone keeps everyone connected.

A 2014 Gallup poll discovered something that may now be obvious: most Americans prefer texting to actual phone calls. Gallup found that the younger the person, the stronger the preference for newer technology. Millennials are attracted to text­ing because the messages get right to the point, aren’t intrusive or overly personal, and can be answered immediately or at a more convenient time.5 Orthodontists can also use software like Dental Monitoring to text patients in a HIPAA-compliant environment, allowing them to bring an even higher level of personal communication to their practices.

The toothpaste is out of the tube, and there’s no putting it back. To compete effectively, orthodontists need to embrace technology that allows them to improve treatment while appealing to this new generation of decision-makers. It’s a marketing tool as much as a clinical tool.

Artificial Intelligence

In 1997, a computer named Deep Blue§ beat the reigning world champion, Garry Kasparov, in a chess tournament staged in New York City. A machine beating a champion chess player was unthinkable at the time, surprising even computer scientists.

Fast forward 20 years to the current evolution of IBM’s AI technology, now called Watson,§§ which is helping medical facilities improve patient outcomes and capture revenue that might have been lost without the processing power of a machine analyzing gigabytes of data at light speed. Among its many uses, the Watson Health§§ platform can identify patients who are non-compliant with wellness visits or have chronic conditions and can alert medical staff to reach out to schedule appointments at the appropriate times. A doctor can ask an AI-enabled computer like Watson a question about a particular case, and the software will analyze data from millions of medical journals to offer treatment option suggestions within minutes. Do you have a borderline case in which the choice of extraction or nonextraction is unclear? It won’t be long until you will be able to scan records into a database and get back the top three most effective, evidence-based treatment plans and their probabilities of success. This will not replace the judgment of the orthodontist, but it will make for better clinicians who can achieve better outcomes.

The precision of AI technology also allows it to see things that the human eye simply cannot. Imagine a future when a remote scan of a patient’s face is input and an algorithm detects the three treatments with the highest predicted levels of success. This kind of technology, already under development in some areas of medicine, may be only three to five years away.

Look at your smartphone. How many times a day does this device enable quicker decisions or provide information at a moment’s notice? But phones aren’t the only things that are getting smarter. Things all around us are being embedded with technology that allows them to talk to us and one another, use adaptive learning to predict what we might want, and communicate with us to tell us their current status. This connected technology has a name—the Internet of Things—and Millennials are surrounded by it. We have thermostats that can be controlled through an app that learns our optimal temperature. We can press customized buttons to reorder products like laundry detergent when we run low, and they will be delivered right to our door the next day. Smart chips built into retainers and toothbrushes are already here.

All this power is at our disposal. Rather than be afraid of new technology, orthodontists need to embrace it, because it will make us better doctors and more successful businesspeople. Technology allows orthodontists to create stronger ties to patients—especially Millennials, who are natural early adopters. It also makes orthodontists better at their jobs. Technology can add to and augment orthodontic skills instead of replacing them.

After IBM’s Deep Blue beat Kasparov, the chess master said he might have done better if he had had the computer’s database at his disposal. Kasparov was onto something. Chess matches were subsequently organized with computers matched up against human players assisted by AI. The AI-assisted humans beat AI-only machines 53 times, vs. 42 wins by the machines.6

Don’t Wait, Innovate

This is the world that we’re racing into headlong. Millennials are not only comfortable with technology, but they expect that everyone has already adopted it for their benefit. This doesn’t mean you have to hook every instrument up to WiFi. Nor does it mean you should become paralyzed by fear. We can prepare our practices for digital changes in steps. But it needs to be done. If you are going to compete in the future as a private practice, you must capitalize on digital innovation. Make changes gradually, and iterate as technology develops. There are plenty of technologies that can turn your practice into a forward-thinking business that appeals to Millennials. Digital Monitoring, social media marketing, and texting to communicate are all easy to implement right now.

Clearly, there is a technological paradigm shift in the way businesses market to their customers, affecting everyone from the multinational Fortune 500 company to the independent orthodontic practice on Main Street. We need to recognize this new world, in which your word-of-mouth reputation for correcting overbites is built through the bits and bytes of the Internet, viewed on mobile devices and reinforced through direct communication. The primary shift in orthodontic culture is from a doctor-centric practice to a patient-centered one. Offering this unique experience will drive continued growth by attracting Millennial parents to your practice.



  • LEON
  • AMY

Dr. Klempner was in the private practice of orthodontics for more than 38 years, is a board-certified orthodontist and lecturer, and is a co-founder of People & Practice, LLC, 2025 Broadway, Suite 25J, New York, NY 10023; e-mail: leon@pplpractice.com. Ms. Epstein holds an MBA in marketing, is a co-founder of People & Practice, and regularly lectures at the Zicklin School of Business, Baruch College, New York City; and Long Island University School of Business, Brooklyn Campus, Brooklyn, NY.

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