Go hybrid – combine digital and physical consultations

Aalok Shukla explains how practices can effectively combine digital and physical consultations to benefit your practice.

Nowadays, our life exists across two worlds – the digital and the physical. And the lines between them are increasingly blurred.

We work digitally through Zoom meetings and email. But we also then catch-up physically for in person meetings. Our social life is no different, we see our friends online, talk on social media and then catch up in person for nights out.

Healthcare has followed the same path. Patients access their GP for digital consults or calls and then come into the clinic when needed for special tests and investigations where deemed appropriate.

A close friend who is a GP in Manchester was telling me that he does 60% of his patient appointments remotely (digital/phone). Only 40% occur face to face.

It means he is able to see more patients per day and be more efficient in his practice.

Dermatology he was explaining is largely managed remotely with equivalent accuracy. Surprisingly he said that his elderly patients were the ones that appreciated the remote consultations the most.

Access to dentists is a topic that is in the media everywhere. The issue is always the same thing, access is restricted. But we all know oral diseases are preventable. So when untreated it leads to expensive and painful problems.

This is the problem, how to scale access?

Technology is the solution to the dental access crisis

Traditionally dentists used to only deliver clinical services when a patient sat in the dental chair.

Now with technology and more dentists embracing hybrid practice, they can offer advice and clinical services which the patient can access through their mobile digitally.

By communicating with patients digitally through photos, videos and messages, you increase the number of patients you can help daily, without increasing your time at the clinic. This frees up your chairtime capacity and increases your hourly rate.

There are three categories of service you can deliver digitally.

  • Screening – identifying risk factors to see if a clinic visit is needed
  • Prevention – delivering preventive advice and/or prescriptions
  • Transformation – monitoring whitening and straightening treatments.

Let’s look at them one by one.


Most adults don’t visit the dentist frequently enough. This is the principle reason why early disease and problem signs are not detected leading to larger problems.

This problem is compounded in children. They can have disease progress rapidly leading to traumatic experiences, which then set up a whole vicious cycle of avoiding the dentist.

A simple approach is to offer digital screening as a way to increase access.

Digital screening is not a replacement for a check-up, but it does form part of an active prevention model. It helps reduce barriers to access such as time and cost.

Patients that have connected digitally with your practice are more likely to maintain engagement and registration. They find the approach more convenient and personalised.

By offering all inactive and active patients the ability to have a digital screening with your practice, you help increase engagement with your services and it helps you determine and advise who needs to come in for treatment. It also creates a more differentiated patient experience.

You can carry out digital screening using a mobile phone as the input device. Or offer a more advanced service using a Dental Scope for advanced screening.

Digital screening can be offered as a new engagement tool to attract new patients directly through email and SMS. Practices can also build it into practice membership plans, thus offering increased value for your patient members.


Digital screening is helpful. But we can go further than observation only and identifying the early signs of disease.

We can actually prevent things getting worse. Different people have different dental risk factors, some people have more vulnerable gums with thinner biotypes. Thus they have more recession and sensitivity risk. Others have more crowding in their teeth and plaque build up increasing periodontal risk. Whilst others have large restorations and grinding habits meaning greater risk of tooth fracture.

By identifying and explaining to patients what their particular risk factors are digitally you can enable more personalised and meaningful experiences when you actually see them physically.

When we identify risk factors, the changes to the teeth and gums generally begin in the reversible zone. If the right measures are implemented the condition can be reversed or at least stopped from progressing.

If risk factors progress further they can become irreversible. They require corrective treatment, which is always more expensive and complicated.

This is where digital prevention comes in and can take many forms such as:


  • Oral hygiene guidance and technique to address specific areas of concern
  • Dietary advice to minimise/reduce erosion
  • Habit advice to reduce nail biting/clenching/grinding.


  • High fluoride toothpaste to manage early signs of caries
  • Fluoride trays to treat sensitivity
  • Nightguard to protect against teeth wear worsening.

By identifying issues early through digital screening and providing preventive solutions your patients can enjoy a higher standard of oral health.

Preventive dentistry is something all patients want. No-one wants invasive treatment if avoidable. This is something that we can build into dental membership plans, which can increase retention and engagement of your patients.


More than 40% of adults are looking for a better smile. There are two main transformations they are looking for – whiter teeth and straighter teeth.

With a hybrid approach you can attract and help a lot more patients. That means that you do more cosmetic work and more people enjoy total smile confidence. So let’s look at how you can do this.

Teeth whitening and teeth straightening both require a prescribed appliance to deliver the outcome. The clinical input is the assessment, diagnosis, monitoring and support. So we can deliver part of this digitally.

Hybrid whitening

We can deliver teeth whitening in a hybrid way by enabling a digital assessment to evaluate potential suitability for a clinic visit. For example not having anterior crowns/porcelain restorations.

So, if they are determined to be suitable the patient could pay a deposit/purchase in full online. Then attend their dental health assessment and 3D scan.

At this visit we can check oral health with any X-rays needed. Take a 3D scan and send it to the lab.

Following this, give the patient any pre-whitening advice and schedule for a hygiene visit if needed. When the whitening trays and pack arrived the patient could attend the practice to collect, and then they could take the pack home and start the whitening treatment, whilst completing a digital review to track progress and compare against the start.

From here deliver digitally any guidance and support. As well as discuss additional cosmetic procedures such as straightening or cosmetic bonding.

This means a happier and more satisfied patient. As well as a more productive practice saving on chairtime on reviews.

Hybrid aligners

Invisible aligners are one of the most in demand cosmetic procedures. But the main barriers stopping patients from proceeding are cost and time commitments.

Demand has exploded in recent years through the introduction of direct-to-consumer aligner companies that introduced a digital journey and a more affordable price thus unlocking latent demand.

The average practice that does five aligner cases a month at £3,000 typically presents eight treatment plans, schedules 10 appointments and has 40 enquiries by email/social.

This means 35/40 patients are not progressing to any treatment. Cost is the main barrier.

By introducing a hybrid model of straightening, you can take advantage of this and greatly increase the access to your services both financially and geographically. It will attract whole new groups of patients. Adding just 50 hybrid cases to your practice can add £137,500+ in new revenue, without any chairtime increases.

To do hybrid aligners properly, you need a dedicated system such as Virtuoso aligners. Here the entire journey and appliances are designed for hybrid straightening.

The patient begins with an online E-consultation, which then allows you to screen suitability. Before the clinic visit, begin a digital conversation. This gives you an advantage as time and speed are key.

Virtuoso uses no attachments and has specially sequenced movements and phased aligner sets to minimise the chairtime needed. Apart from the IPR session, which is charged separately, the typical case requires three 10-minute visits during the straightening process. This means you can offer the solution for a much more affordable price to the patient, such as £1,650.

Thus it attracts a lot of patients that would otherwise visit a direct-to-consumer company.

Apart from the in-clinic pickups of the next aligner batches, the patient conducts their monthly reviews digitally. Thus it saves chairtime and offers the patient a much more comfortable experience.

You can also review oral health by reviewing videos taken up close by the Dental Scope. That means you can recommend any further hygiene visits or prevention needed for the patient.

As all images are visible to the patient it helps them to track their progress and see how far they have come.

Examples of cases you can treat are visible here:

All of this means you can promote a clear digital patient journey and thus attract a lot more patients.

The power of going hybrid is that you can expand access to a lot more patients and play your part in making dental care accessible to all.

To learn more contact [email protected] to request your Virtuoso dentist information pack.

You can also view more information at www.virtuosoaligners.com.

Or see our webinar ‘Secrets to starting more aligner cases‘ on dentistry.co.uk.

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