Night guards and ortho appliances: the margin play

Night guards and removable ortho appliances are the highest-margin services you're probably underusing.

Material cost runs 15-30 dollars. Lab time is 10 minutes. Revenue per case ranges from 300 to 800 dollars depending on your market and material grade. That's 80-90% margins. Compare that to a crown at 50-60% margin after lab and team time.

Many practices make one night guard per month. You should make 8-12. Most patients grind. Most could use ortho. But without a system for presenting these cases, you're ignoring free money.

Build a simple screening system. Have hygiene ask one question: "Do you ever wake up with jaw pain or notice your teeth wearing down?" Present night guards to every positive answer. Treat ortho like minor dentistry, not major specialty. Most patients can tolerate a clear aligner tray for 8-10 months at $400-600 total fee.

Slot thirty hours monthly for removable appliances. Run the numbers. A practice adding 8 night guards and 4 ortho cases monthly adds $50K-75K annual revenue with zero new patients. That's leverage.

Start tracking uptake by patient. Which hygienists present most cases? Which ones don't mention it at all? That's your lever. Train up the weak presenters.