With economic pressure mounting and patient behavior evolving, the most successful orthodontic practices in 2025 will be those that rethink every step of the patient journey to improve one critical metric: orthodontic case acceptance. From smarter financial options to refining the observation (OBS) pipeline and targeting adult patients, the key to growth this year is converting more of the demand that’s already walking through your doors.
Here’s how leading industry experts say you can take action to drive growth and stay ahead of the curve.
📉 Industry Recovery is Underway—But the Funnel is Leaking
Ryan Moynihan, CEO of Gaidge, analyzed data from over 2,500 orthodontic locations and found signs of renewed momentum: “For the first time in two years, we saw growth in both net production and collections. But we’re still facing real challenges.”
The real concern? Conversion leakage. Practices received about 1,000 calls, but only 635 patients started treatment—a stark drop-off that highlights missed opportunities.
“You have 1,000 people calling, 871 showing up for exams, and only 635 starting. That’s a huge opportunity gap,” Moynihan noted. “The conversion rate from exam to start should be in the 80–90% range. Practices need to tighten this up.”
How OrthoFi helps: Use OrthoFi’s intelligent workflows and real-time dashboards to track every patient through the funnel. Automated follow-ups and clear action items help your team recapture pending opportunities before they fall through the cracks.
👥 Adult Patients Are the Future
Demographic shifts are reshaping the market. As Shannon Patterson, Partner at Bentson Copple Patterson & Associates, explains, “The U.S. birth rate is declining and is expected to impact school enrollment by 4.5% by 2030. Fewer children means fewer adolescent patients in your pipeline.”
At the same time, adult exams are trending upward. “There are still a lot of practices that don’t want to offer limited treatment options. But practices must adjust to target and convert adults more effectively,” Patterson said.
And yet, despite the rise in adult interest, aligner starts, which make up 26% of treatments, declined by 5%. This gap between demand and starts is an urgent issue.
How OrthoFi helps: Invisalign’s Flexible Payment Terms program, exclusively for OrthoFi & OrthoBanc customers, makes it easy for your practice to increase your mix of aligner cases without impacting cash flow. Learn more →
💳 Stop Letting Down Payments Hurt Case Acceptance
Why are aligner starts dropping even as adult interest rises? One major culprit is the high required down payments.
“Practices are still asking for large upfront payments to cover lab fees, and that’s sales prevention,” said Oliver Gelles, CMO of OrthoFi. “In today’s economy, that kind of financial barrier is turning people away.”
OSOs, by contrast, are growing their aligner volumes. “They’re removing friction,” Gelles said. “They’ve negotiated better payment terms, adopted third-party financing, and offer more flexible payment options.”
How OrthoFi helps: With OrthoFi’s Open Choice model, patients choose the down payment and monthly plan that works for them, without increasing your financial risk: more starts, fewer collections headaches.
🔁 Reimagine Your OBS Program
Observation (OBS) patients are often seen as guaranteed future starts—but that’s not the reality.
“We tracked static cohorts of patients over multiple years and found that only 62% of OBS patients convert to treatment,” Gelles explained. “That’s dangerously close to your general pending conversion rate. OBS isn’t locking patients in the way you think.”
Why? Because there’s often no commitment, no financial agreement, no structured plan, and no consistent communication. Instead, budget-friendly pre-treatment contracts can lock in commitment before treatment starts.
How OrthoFi helps: OrthoFi gives you tools to proactively manage your OBS list with multichannel, automated nurture flows.
🚀 Efficiency and Convenience Are the New Differentiator
Today’s patients are conditioned by Amazon, Uber, and other seamless digital experiences. That mindset carries into healthcare, including orthodontics.
“Patients care most about five things: efficiency, convenience, knowledge, ease of doing business, and friendliness,” said Chris Bentson, Partner at Bentson Copple Patterson & Associates. “Practices need to ask themselves—how are we delivering on those values?”
He emphasized that technology adoption and process automation are essential. “Monitoring solutions, patient portals, and virtual consultations aren’t just nice-to-haves—they’re becoming table stakes.”
How OrthoFi helps: OrthoFi’s mobile-friendly onboarding makes it easy for patients to complete forms and sign their contract anytime, on any device. Eliminate bottlenecks at check-in and free up your team to focus on care.
Make 2025 the Year of Smarter Growth
If there’s one thing that became clear, it’s that success in 2025 isn’t about a flood of new patients. It’s about making the most of every opportunity.
“Your growth this year will come from better systems, smarter financial models, and more targeted engagement,” Patterson said. “Affordability, access, and experience will be the key drivers of success.”
Orthodontic case acceptance isn’t just a metric—it’s the heartbeat of your practice. Nail your conversions, and the rest will follow.
🧲 Want to increase your orthodontic case acceptance and simplify patient payments? Book your Discovery Call today.