The Efficiency Equation: Rethinking Treatment Timelines and Patient Compliance
Recent Gaidge data for 2024 shows that more than 25% of orthodontic patients are in treatment beyond their estimated completion date (ECD). That’s a staggering number—one that should make all of us reconsider how we talk about care, set expectations, and deliver treatment efficiently.
Overpromising Creates Overextended Treatment
It’s tempting to shorten estimated treatment times to increase conversion, especially in lean times. But when we overpromise and underdeliver, no one wins—not the patient, not the parent, and certainly not the practice. Setting realistic treatment expectations from day one builds trust and prevents frustration later when patients inevitably ask, “Why is this taking so long?”
If national numbers show that one in four patients are exceeding their projected timeline, it’s worth performing a common factor analysis on why this happens. Compliance is one of the biggest culprits.
The Compliance Factor: A Treatment Bottleneck
Compliance issues extend treatment length, drain practice efficiency, and lead to patient and parent frustration. But instead of fighting the same battles over and over, we should be looking at ways to engineer compliance out of the system—or at least front-load compliance to the most effective phase of treatment.
I understand that there are many choices for “non-compliance” saggital correctors. In our office, we use the Motion appliance for Class II correction because it demands the most compliance at the beginning of treatment, when motivation is highest. Compare that to other treatment mechanics where compliance is required throughout, and you start to see how front-loading effort leads to better patient participation and faster results.
Using Remote Monitoring to Improve Compliance
One of the most powerful tools we’ve added to our practice is remote monitoring. It provides:
-More frequent touchpoints with patients, reinforcing good habits.
-Data-backed compliance tracking—when a parent questions why treatment is taking longer, we can show them non-compliant scan patterns.
-Faster interventions—instead of waiting six weeks for an in-office visit to address an issue, we can correct the course in real time.
Remote monitoring isn't just about efficiency; it’s about accountability. And accountability leads to better compliance.
The Hard Truth: Sometimes, Ending Treatment is the Right Call
This may be controversial, but there comes a point where continued treatment yields diminishing returns. If a patient is consistently non-compliant, we have to ask ourselves:
Are we continuing treatment in the patient’s best interest, or just delaying the inevitable?
How much time and energy are we spending on cases that won’t reach the desired outcome?
What message does it send to the compliant patients and parents when others are allowed to drag treatment out indefinitely?
Orthodontics is a team sport—we, the patient, and the parents all have to do our part. If compliance isn’t happening despite multiple interventions, we should not be afraid to have the tough conversation about ending treatment early. This protects practice efficiency and sets clear expectations for all patients moving forward.
Building a More Efficient Practice
The key to reducing treatment inefficiencies isn’t just shortening treatment times—it’s managing expectations, optimizing mechanics, leveraging technology, and enforcing accountability.
Set realistic timelines from the start to avoid overpromising.
Reduce reliance on compliance with mechanics that front-load patient effort.
Use remote monitoring to provide more feedback and evidence-based compliance tracking.
Know when to call it—some cases just aren’t worth the additional time.
Efficiency isn’t just about speed; it’s about effectiveness. And when we refine our processes with these principles in mind, we create a practice that runs smoother, patients who are happier, and results that speak for themselves.
