Episode 4

AI in Orthodontics

November 05, 2026 · 00:45:37 · with Karthik Vinayagamoorthi and Nourah Kader

Karthik Vinayagamoorthi and Nourah Abdul Kader are the Co-founders of BerryStudio, an orthodontic patient experience and management platform that streamlines practice operations through integrated technology and automation. Karthik brings an MBA and dental consulting experience, specializing in practice operations, financial performance, and technology-driven growth, while Nourah is a board-certified orthodontist who provides the clinical perspective behind the platform. Together, they have grown BerryStudio to about 41 practices across the US and Canada and received the 2025 AAO Ortho Innovator Award. They have also implemented the platform in their own California practice, increasing production by 56% while reducing overhead by 22 percentage points. This is the third company Karthik and Nourah have built together as a married entrepreneurial team.

Here’s a glimpse of what you’ll learn:

[2:22] Karthik Vinayagamoorthi and Nourah Abdul Kader’s path from orthodontics and consulting to entrepreneurship
[6:48] How practice inefficiencies and rising overhead shaped the idea behind BerryStudio
[8:32] Early growth, industry recognition, and expanding adoption across orthodontic practices
[14:51] Why Karthik believes AI should support people rather than replace them
[18:08] Nourah’s perspective on making clinical and digital workflows more efficient
[21:54] Where AI could have the biggest impact on orthodontics in the coming years
[31:04] What high-performing orthodontic practices are doing differently to drive growth and profitability
[35:08] Karthik’s thoughts on emerging technology, remote monitoring, and the changing orthodontic market
[39:41] Nourah’s advice for embracing new technology and lessons on building a strong company culture

In this episode…

AI in orthodontics is becoming less about flashy technology and more about solving everyday practice problems. The biggest gains come when technology simplifies workflows for teams and improves the patient experience. So where can orthodontic practices use AI to become more efficient without losing the human side of care?

Karthik Vinayagamoorthi, an orthodontic practice-management consultant with expertise in digital workflows and practice growth, believes AI should make existing workflows shorter and more efficient rather than replace people. Nourah Abdul Kader, a board-certified orthodontist, sees opportunities in areas like lab workflows, task automation, digital case management, and patient communication. Karthik also emphasizes that AI alone will not grow an orthodontic practice — doctors still need strong fundamentals, accountability, and a clear understanding of profitability. Their approach offers a practical roadmap for orthodontists exploring AI: Solve real operational problems, start with manageable changes, and use technology to create a better patient and staff experience.

In this episode of Straight Talk With EPIC4, Anne Wemhoff talks with Karthik Vinayagamoorthi and Nourah Abdul Kader, Co-founders of BerryStudio, about AI in orthodontics. Karthik and Nourah explore workflow automation, voice charting, and technology-driven practice growth. They also discuss the patient experience, remote monitoring, profitability, and how orthodontists can adopt AI without losing the human touch.

Resources mentioned in this episode:

Quotable Moments

“We should not build AI to replace workflows or replace what humans are doing.”
“AI is just one of the tools that's going to help you grow.”
“I believe you need to have that internal hunger.”
“It's been super easy for us to check and visualize what's going on.”
“People are so used to instant gratification.”

Action Steps

Use AI to shorten workflows, not replace people: Focusing automation on decreasing repetitive tasks can reduce staff burden while preserving the human interaction patients and teams still value.
Start small when introducing new technology: Testing AI and digital tools in manageable ways helps teams build familiarity without becoming overwhelmed by sudden operational changes.
Evaluate technology through the patient experience: Making forms, communication, and clinical processes easier and more intuitive can help practices meet rising expectations for convenience and speed.
Track profitability at the visit level: Understanding profit per visit, rather than focusing only on revenue, helps practices identify costly workflows and make smarter operational decisions.
Keep ownership of your practice’s growth: AI, consultants, and strong teams can support growth, but lasting progress still depends on the doctor’s internal drive to improve.

Sponsor for this episode...

This episode is brought to you by EPIC4 Specialty Partners.

At EPIC4, we partner with specialty dental practices, including orthodontic practices, led by doctor-owners who want partnership, growth, administrative relief, or succession support without joining a traditional DSO.

Our mission is to help you spend less time buried in payroll, HR, compliance, lease negotiations, and day-to-day administrative tasks — and more time focused on patients, teams, growth, leadership, and legacy.

EPIC4 is a doctor-founded, doctor-centric Specialty Partnership Organization built to help dental specialists scale their practices, create wealth, protect their autonomy, and build an EPIC life and practice.

Visit www.goepic4.com today to learn more.

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Episode Transcript

Intro: 00:07

Welcome to Straight Talk With EPIC4, the specialty dental podcast, showcasing bold leaders, innovators and change makers as they share candid insights, lessons, and actionable strategies. Ready for real conversation? Let's dive into today's episode.

Anne Wemhoff: 00:25

Anne Wemhoff here. I'm the host of the EPIC4 Specialty Partners podcast, where I talk with inspiring specialty dental leaders and doctor owners who are building successful practices in shaping the future of dentistry and specialty dentistry. Today, we'll share stories, insights, and strategies from entrepreneurs, leaders, and leaders across specialty dental fields.

Today, we are sponsored by EPIC4 Specialty Partners. At EPIC4, our mission is to help you spend less time buried in payroll, HR compliance negotiations and day to day administrative tasks, and more time focused on patients, teams, growth, leadership and legacy. EPIC4 is a doctor founded, doctor centric specialty partnership organization built to help dental specialists scale their practices, create wealth, protect their autonomy, and build an epic life and practice. For more information, check us out at GoEPIC4.com.

Before I introduce my guest today, I want to give a big shout out to Liz Sudit from Bright Referral for putting me in contact with Karthik and Nourah from BerryStudio. BerryStudio is an orthodontic management system in the industry. And welcome to the show today guys.

Karthik Vinayagamoorthi: 01:52

Thank you so much for having us and.

Nourah Kader: 01:54

Thanks for having us. Anne. And Liz is awesome. I'm glad we became friends with her. She's just an amazing founder.

Anne Wemhoff: 02:02

Isn't she? I love her, love her to death. Well, tell me about you guys. Like, what inspired you to to co-found BerryStudio? What problems were you trying to solve for other orthodontic practice practices when you had this idea in mind?

Karthik Vinayagamoorthi: 02:22

I can give the long version and then I can shorten if need be. So Nourah and I are also husband and wife, and about a few years back, when Nourah was applying to orthodontic residencies, we were. I was working at Invisalign as a consultant on their team called Adapt. My focus was mostly helping practices that, you know, increase their digital share of chair, manage cash flows much better. But as part of that, when you go to a private practice orthodontist and you're like, ask them questions about why are you losing money?

They become very transparent with you and they tell you all their problems. So even before I knew how an orthodontic practice can grow and earn money, I knew how orthodontic practice can lose and kind of leak money along the funnel. I have an MBA degree, so luckily that helped with my financial analysis, and one year of doing that taught me a lot about orthodontics. Gets into ortho school, she studies and graduates from UIC in Chicago, and she graduated last year. And when she around the time she graduated.

Thank you. Yeah. So it's only been a year since she graduated, quite honestly. And at that time, we were effectively exploring an associate to partnership position at another friend friendly Orthodontist's office. It just so happened that that opportunity did not pan out, but before the opportunity did not pan out, the doctor basically said, I've been spending a lot of time and money trying to like reduce my overhead, but I've not been doing a good job at it.

Can you help with that? Nourah and I worked on his PNL for one year. We came up with different ideas, you know, borrowing from our own experiences, implementing technology in her residency program and using Invisalign. And we were able to significantly reduce his overhead. He saved about $128,000 in the first year.

Wow. Yeah, that was huge. Right? For a big practice and that after that first year, while we did not go through with the partnership because the doctor felt like he was not ready to bring on an associate, he turned around and actually became our angel investor and said, you guys have done a lot for me. I'd be more than happy to invest if you made this idea a company.

So that's how BerryStudio was born. It was born. Not not that we planned for it, but we helped one doctor become successful. And we just wanted to replicate that success amongst more doctors. And when we actually had dinner with Liz and her orthodontist spouse, Dr. Geoff Sudit, did they were they actually kind of challenged Nourah.

They're like, you know, you've not seen the real world yet. You're still a resident. And that challenge was a good challenge for us. Liz is really good. Good like that.

She gives it to you straight.

Anne Wemhoff: 05:27

And a dose of reality, right.

Karthik Vinayagamoorthi: 05:31

I know she's like, you know, if we are preaching people to buy a software we built, we have to first implement it in our own backyard. And that's how we bought a practice in California. In the last one year, we've managed to implement BerryStudio and significantly grow it. We've grown about 56% in our first year in terms of production, and we have managed to reduce our overhead in California by about 22 percentage points to 64% overhead. So I think we're definitely doing something right.

We want to take this whatever we're doing right and help more doctors also, you know, become more profitable in the due course of things, implementing good technology. So yeah.

Anne Wemhoff: 06:21

Go ahead, go ahead.

Karthik Vinayagamoorthi: 06:22

That's the long version Nourah is much more succinct than I am.

Anne Wemhoff: 06:25

I love that I, I'm so curious to learn more though. So the nitty gritty is really, you dive into a practices PNL and you find ways to really optimize where they might be losing money or like what, how, how do you use technology and how does that all like, how does it all work together?

Nourah Kader: 06:48

So it's less about figuring out ways in which we can save the money. It's more about evaluating where they're leaking money, in the sense that there was a lot of different technology that they were using that could have been just one single software, but it just doesn't exist. And then the one that what we did for this orthodontist that I was working with for a partnership is we were trying to bring a lot of things that he was doing with outside systems in-house, and just try to optimize what existing software that he already had for practice management. So when we started doing that, we realized how many drawbacks there were with existing practice management systems, which makes the orthodontists like go and look for another software outside or services. And then you keep adding on and on and on.

It's like we have Netflix, Hulu, Peacock, all of that. And you it can't. And you have multiple other subscriptions. So we thought about really in a very selfish manner. Initially we started our own practice.

What would that be like? We really wanted to build that one single solution software so that you're not spending a lot of money doing buying all these other different software systems, which keeps adding on to your overhead instead of decreasing. And then you'll add a software and then you need a human to manage that. Now you're adding more human resources as well. So that's where the idea came about.

We didn't have a software when we first saved that much money and when he invested in us, but now we do.

Anne Wemhoff: 08:25

That's awesome. I mean, so you guys, how long have you been around? You're new. Right? Did you say a year?

Karthik Vinayagamoorthi: 08:32

Yeah, we've been around for a year. Last year, as a concept, we submitted our initial prototype to the AAU, and we were recognized with the AAU Auto Innovator Award last year. And that's really what put us on the map.

Anne Wemhoff: 08:47

And congratulations.

Karthik Vinayagamoorthi: 08:48

Thank you. So it's been that was the last me. It's been about a year and a half since we launched the product. Today about 41 practices are using the product across the country in US and Canada in different capacities. And we are slowly trying to grow.

Our real big goal is on January 22nd next year at the AAO midwinter meeting. We're kind of doing a major product launch and that's that'll be our official time. We kind of launch into market.

Anne Wemhoff: 09:20

Okay, I love it. So, you know, you guys, we had a little pre-chat before this and you mentioned that Barry pay. So tell me, I'm not familiar with that. I don't know. Our listeners are probably not familiar with it.

So how does it work? What challenges was it designed to solve at that orthodontic practice level?

Karthik Vinayagamoorthi: 09:44

Great question. A lot of orthodontic practices use a separate payment system which integrates with their PMS. So let's say my core PMS is something like Greyfinch or Cloud 9 or Ortho Edge. They then would use a third party service that would manage their payments and then deposit the money into their ledger. Now there are two things that happen.

One is you lose significant amount of money in merchant processing fees. The average orthodontist at least pays close to 2.3% in merchant merchant processing fees. And if they use it like some expensive services, they could even pay as much as 3%, like global pay and so on. The second thing, place where you kind of lose money is especially when you negotiate with insurance and you use a third party service like Zelis, you again lose close to 2% in your margin processing fees over there between virtual credit cards and direct deposit. So you either have to lose money, or if you want to be super conservative, you've got to push all your patients into ACH.

You have to collect all your insurance checks, insurance payments by cheque, and then do a manual process to save on merchant processing fees. And during this.

Anne Wemhoff: 10:58

Which is super time consuming and nobody has time for that.

Karthik Vinayagamoorthi: 11:02

Exactly. And in the super manual process, it's just that there are so many breaking points where you could self embezzle yourself. One simple example is there is no system. I think with the exception of Greyfinch, that has true auto pay, right? Every system where the automatic payments need to be triggered, and then the payments have to be posted back.

And these are separate manual actions that most financial coordinator has to do, or you end up, again, outsourcing it to a third party who charges a significant amount between 600 and $50 a month to even 2.3% of collections just to do that for you. The insurance collections and then post payment posting back to the system. So we noticed that there are two places where you can significantly lose money and that's like off your top line. So better pay solves that problem. Instead of focusing on building a separate ledger and a separate payment processor.

We built both together. So it's not like you are plugging in global pay with ortho two edge or like payable with Greyfinch. It's just one platform, which is the both the payment processor and the ledger.

Anne Wemhoff: 12:14

Wow.

Karthik Vinayagamoorthi: 12:15

Because we do that. We are super competitive in terms of not charging a merchant fee to the doctor. So on average, for doctors who've processed about $2 million through our platform so far. They have only paid 1.8% in total merchant processing fee, irrespective of whether the patient used visa, Mastercard, Amex And that's, that's a huge saving.

Anne Wemhoff: 12:40

Significant savings. Yes.

Karthik Vinayagamoorthi: 12:42

Apart from this, there are like so many, if you're doing a manual reconciliation process, it's a truly automatic auto pay system. There is no requirement of third party PCI compliance. There is no requirement for going and changing individual fields in order to accommodate or reconcile between different accounts. It's a more intuitive ledger system where the burden of manual actions is reduced significantly for the financial coordinator. So if I were to summarize it, you would say if you process about $100,000 per month, you will save close to $1,000 in fees and you will save close to about 15 hours of the financial coordinator every month in the regular steps that they have to do.

Anne Wemhoff: 13:28

Wow.

Karthik Vinayagamoorthi: 13:29

From the perspective.

Nourah Kader: 13:30

Of from the perspective of the doctor, you're always trying to find something that's more efficient and easy to visualize. And that's where this tool comes in, because it's not inspired by any tool that's already in the industry. We try to look for inspiration outside, so it's easy to visualize what's do what's been paid, what's delinquent, all of that. And if you wanted to refund something, it's not like a request that you need to place and then go to the payment processor, see what happened. It's it's a quick, easy button and audit trail everywhere.

So you know exactly what happened. It's the audit.

Anne Wemhoff: 14:06

Piece is real, real key. I love to hear that.

Nourah Kader: 14:09

Yeah. The audit piece is great. And that's like a big reason why we were able to decrease our overhead to in our practice, because we only have one remote financial coordinator. Nobody in the office. And it's been super easy for us to check and visualize what's going on.

Anne Wemhoff: 14:26

I love that. I think, you know, you guys had to have at some point, some type of moment. I mean, just listening to your story and how much you've evolved, even in a year, the short amount of time. Was there a specific experience that made you realize, hey, we have to do this? We need to find this better solution?

Like, what was that?

Karthik Vinayagamoorthi: 14:51

I think, I think the first moment was when we started doing insurance verification. And so everybody, you know, they sold this the world, we drank the Kool-Aid that, you know, AI is this miraculous solution that can call insurance companies and do what the human can do and get the insurance information back. And in fact, that was the first thing we ever built. We built an AI chatbot that would call the insurance company, speak like a human, get the benefits faxed, read the facts, and then post the information into their studio. But then guess what?

When it hit the real life, it did not work. That's because most insurance companies to reduce their customer service costs. They have hired large teams in three specific states Utah, I forget the other two. So basically states that we don't have high income workers per capita income. And in these three states, they have like, like large amounts of people sitting behind phones answering questions.

A few more insurance companies have outsourced that operation entirely to Philippines, but most of it is within continental US because of the sensitivity of data. And then you would call the insurance company the first. You would spend 20 minutes with like a, you know, a AI system or a call bot. It will basically ask you, what's the doctor's pin number? Press one, press two, and give all this information.

But everybody knows that that answering machine will never give you all the key information that you need to verify insurance. For example, the answering machine cannot tell you if the insurance is going to be paid annually or monthly. Is it going to be paid to the doctor or the patient? So you still need to speak to someone. And as soon as the human being on the other end heard an AI voice, which is polished and smooth and error free, many of them would say, no, f you AI and keep the phone down.

So that was a reality check that blew our mind. We were like, wow, the companies that are implementing AI to replace their staff, their staff hate AI. That's kind of speaking to them. So AI is not a foolproof solution when it interacts with people who feel vulnerable about it. And when that that was an moment that we had.

So we said we should not build AI to replace workflows or replace what humans are doing. We should build AI to shorten workflows of what humans are doing. This one fundamental shift changed our whole perspective on how to use AI. And that's how that's how we started appreciating the product more. We're like, we should make a product that works for staff in the way they work, and then probably shorten that workflow.

We should not make a product that replaces that stuff entirely from the workflow, because they're going to be the first person to not use it and convince the doctor that this is the worst part of their job.

Anne Wemhoff: 17:43

I think that's so interesting. And I think, you know, with AI, so much has changed. I mean, within the auto industry in the last year. And I mean, where do you see AI taking the auto industry, the specialty dentistry? I mean, in the next, you know, 2 to 5 years.

Karthik Vinayagamoorthi: 18:03

Do you want to speak about the clinic first?

Nourah Kader: 18:08

Yeah, I mean, I can talk about it from the clinic perspective. And I think that it what I'm saying would resonate not just with younger providers, but also providers who have been practicing orthodontics for a while now. And one of the things that takes the most amount of time has the most amount of errors. and people are still trying to figure out is lab workflows. It's just all over the place, especially with so much digital dentistry that we're doing right now.

We tend to forget how much homework that adds on to the team and the doctors. And in our practice, for about 80% digital, 20% analog. And the first day that we bought the practice, the office had color coding for sticky notes of what sticky note meant, what. And right now we have no sticky notes in the office.

Karthik Vinayagamoorthi: 19:00

Yay!

Nourah Kader: 19:00

I think.

Anne Wemhoff: 19:02

That's big in.

Karthik Vinayagamoorthi: 19:03

Itself. Yeah.

Nourah Kader: 19:05

So one of the automations that we're building with BerryStudio is our task management product, which is very similar to Asana, except it's built into BerryStudio. So it's linked with the patient's chart everywhere. So from the time the patient gets added as a new patient to their forms being sent out, their reminders being sent out a treatment chart being created. If they have a lab prescription that. And then to that.

We also recently integrated with Invisalign. So if it's a practice that's Invisalign heavy, then you can automatically track the progress of that case in BerryStudio. And we have next phases. Like you can submit a prescription directly to BerryStudio. You don't have to go through the, you know, the align system to do that.

So there are different things that we're doing to automate that workflow so that we can decrease the load of what the digital dentistry is doing for us. And I think that for any orthodontic practice, bringing that AI element in here is going to be just tremendous in terms of the amount of time that will save us and possibly decrease, you know, the human source. That's human resource that's needed as well, because everybody who talks about digital dentistry, they always say you're more digital, then you should decrease your, you know, the number of people in your practice to. But it's not always true, right? It's not.

It's not 1 to 1. And then we always notice that you end up needing those humans to take care of these digital processes. But this is where we think that we could improve that. And it goes back to what Karthik said about that fundamental shift. You're not trying to replace the human.

You're just trying to make that workflow shorter and more efficient so that you may not need three people to take care of this one task. You just need one efficient system and maybe, you know, two people who are really good about managing that system.

Anne Wemhoff: 20:54

Yeah, I love that. I mean, and I think, you know, there's so much conversation on AI taking over the that, that role and, you know, the reduction in what that can mean for the workforce. But I really think you've hit the nail on the head there because you still need the people and people still crave. I mean, much like your insurance example and what you learned, right? People still want to talk to people because you do get annoyed.

You're like, no, I want to talk to a human, you know, and and so I think that as we see AI, you know, go on not only at the clinical level, Karthik, I know you're going to kind of talk about it the brighter, the wider level too, but I still see that there is going to be a need for that human touch and that human interaction. So maybe you can talk about that on a wider scope or, you know, where you were going to go from from that direction. What do you think from that, you know, 2 to 5 year perspective from the broader scope, how do you think AI is going to change the industry?

Karthik Vinayagamoorthi: 21:54

It's actually a pretty cool question. So there are basically largely two types of AI. One, one kind of AI is generative. Another kind of AI is like this shortens workflows, meaning it takes a repetitive tasks and then it repeats that over and over again much more efficiently. I believe all of the orthodontic innovation is in the next couple of years.

It's going to come from that workflow. AI. There are very few companies focused on the generative aspect of AI. Like there's obviously a line. There's obviously DentalMonitoring in these companies.

They're working on generative where they're taking multivariate input and then trying to find a deterministic output and help doctors diagnose better or like check compliance better or check hygiene better. There are going to be very, very few companies. And the bar for them to cross from an FDA perspective, is super high. So there's going to be a very small innovation there in the workflow perspective. We can already see a lot of examples coming through of companies trying to implement AI.

I think two companies that have really shown what's possible is there's LeadSigma, which has really shown that, you know, you can have AI in a top of funnel trying to answer phone calls and, and then effectively get new patients in the door. A good alternative for that is obviously like trying to have somebody pick up the phone and answer it around the clock, but then do it from a HIPAA compliant environment from a different country. It both comes out to be the same price. In the end, it's just about whether your audience likes it. Like in Berkeley, where we are, you might assume that everybody's a tech focused on the Bay area.

Honestly they're not. When it comes to picking up the phone, they hate even like the the message that goes out that says, this call is being recorded for training purposes, they just immediately keep the phone down. So we've decided to go all in with just humans picking up the phone. And there are like great services like SmileSuite that can do that for you remotely as well. So that's, that's one place where like there's going to be a conflict, but a healthy tension between can we go all AI or all human?

Another place where there's going to be a lot of innovation. And we've implemented a system called BerryFlow and our practice is chat side note taking. So in, in our clinic, basically what we do is we have a microphone next to every workstation, and we made the the keyboards intentionally a little janky so that people are discouraged to type type in there. And we told them, just speak into the microphone. So they would speak their notes into the microphone.

It would translate that into a Soap format or a specific format depending on the appointment type. And then that Soap format would then create three artifacts. One is a progress note you could directly post into your PMS. The second is a console or treatment letter that you could send to a referring dentist or to a specialist. And the third is a referral letter.

If you want to request a specific extraction or so on. The fourth one, which is still in progress, is a prescription, especially if there's an appliance like an additional aligner appointment or a new, you know, you suddenly want to switch somebody from braces to like, you know, aligners. How do you do that? You want to create a prescription on the spot and then issue that to the, the company. So this kind of workflow manipulation is, is what I think AI will lead us.

I think there'll be more innovation in that workflow side and less innovation on the diagnostic side. But let's see how it turns out.

Anne Wemhoff: 25:26

I love it. That's so it's exciting and interesting, and I can't wait to see it all unfold. I think it's going to be interesting to see how our industry changes in the upcoming years. And, you know, from from that perspective, what do you think like separates a practice that embraces that new technology successfully from those that, you know, are like, oh, I'm not really sure. Like, what do you see differences in that?

Karthik Vinayagamoorthi: 25:57

I great question. I mean, we are too young to make a judgment on the industry. We've only been doing this for one year. I think no matter how old or how which location the practice in if the doctor is hungry for growth, they will grow. AI is not a be all done all solution for growth.

There are many ways to grow. I realization in year one of growing our practice is that you don't always have to chase the shiny object to grow. You. Sometimes you need to go back to the basics and do the very simple, mundane things like showing up at your dentist's office and like really making sure that, hey, this is not a random girl walking into your door. This is the orthodontist and she is very well qualified to the.

Anne Wemhoff: 26:43

Marketing heart makes it so. It's so happy to hear that. Karthik.

Karthik Vinayagamoorthi: 26:48

Yeah, like that's the part that hurts the most. But I drive her around and she drops off every single, you know, month or week to doctors. And you know, that's where we find the most growth from. Like it was not AI. It was not some complex technology we implemented.

So I believe hunger is the answer, like having this underdog mentality of like, always having to chase and having to become better will give you a growth. AI is just one of the tools that's going to help you grow. But if you, whenever you like, transfer the accountability of growth from you to somebody else, whether it's a director of operations, whether it's an AI tool, whether it's a third party consultant, I think you're not going to grow. I believe you need to have that internal hunger. And then you can, of course, take support from good tools, from good teams, from good consultants, from good managers to help you bring that growth, that hunger, that underdog mentality to life.

This is my personal perspective.

Anne Wemhoff: 27:45

Yeah, I think I couldn't agree with you more. You know, because you can't teach that and you can't have an AI bot do that for you. You know, you have to have it in me to want to, to want to grow and to want to figure out where, you know, you may be losing money or where you can make adjustments to, to really, you know, go out there and hit the ground running, you know, and whatever capacity that is. So that kind of leads me to my next interesting question. You know, you're working with practices.

What trends do you see among the fastest growing offices today? Orthodontic offices, like from a technology standpoint, or just in general of something that's like that is working and that is awesome.

Karthik Vinayagamoorthi: 28:30

But I think the.

Nourah Kader: 28:31

Answer is so, so varied depending on where they practice. And you know, everything else they do. But there's definitely one that stands out to me when I, when I talk to practices that are really, really successful is they've really embraced digital technology, whether it's clinical or whether it's, you know, admin related, they've embraced that and tried to, you know, race up to wherever the world's leading. That's not to say that AI is the one all solution for everything or whatever we're doing, but it's, it's kind of staying abreast of what's happening outside because patient experience is also changing. Everybody is so used to instant gratification.

You, you know, you order something, it's here the very next day. You can visualize it in your room to see what that's going to look like.

Karthik Vinayagamoorthi: 29:17

Yes.

Nourah Kader: 29:17

Or on yourself. So if you're, if you're still not embracing that technology to help them visualize what that change would be. Because end of the day, you need, we can say all these fancy things, but the practice grows when you have patients in the door when they're starting treatment. So I tend to go back to that. And that's where I think one of the things that very studio, we don't call it a practice management system or we call it a patient experience platform because we wanted everything that we've built is around patient experience.

What are they going to feel when they're doing this? Right? The health history forms, for example, that we've created, is fully digital on the phone. You can complete it halfway, forget about it, come back and still be okay, like starting wherever you were and not start over all over again and just, you know, sign once everything that we've done is for the population right now where you're just like instant gratification, they don't have a lot of attention span. You have to get them when they're and they're still paying attention to you.

So that's just kind of an example. But in any sense, evaluating like, where are people at at this age and how fast things are moving? If people are able to embrace that, then I think they grow. This is what I've noticed. But yeah, I think you can share too.

Anne Wemhoff: 30:39

You talked a little bit about that, like from a practice level perspective, you know, in the operational piece, what, what would be, you know, if you could say, hey, you want to you, if you want to create a better patient experience, what would you recommend they focus on first?

Karthik Vinayagamoorthi: 30:57

I can give a few examples, but on the previous question, I have an opinion too, but.

Anne Wemhoff: 31:02

Yeah.

Karthik Vinayagamoorthi: 31:03

Yeah.

Anne Wemhoff: 31:03

Go.

Karthik Vinayagamoorthi: 31:04

For, I think practices that grow. I think today focus on like three key trends. One trend obviously is the adult market. I think the more we focus on adult market and we know how to effectively compete with general dentists who also do clear aligner therapy, we can tend to grow. The market is growing, the orthodontic market is growing, but the share of the orthodontic market captured by orthodontists is continuing to decline.

And if you have to like stay competitive with your own referral sources, then you need to innovate with new ways and methods. And there are many new innovations, but you have to choose which, which is your lane and compete that way. Some people raise the bar, some people offer orthodontic as a consulting service. Some people like bring pediatric practices in-house and like bridge the gap. Some people buy out the referral source, which path you take is yours.

But if you have to figure out that that's both a threat and an opportunity and needs to be done well. The other area, which there's a lot of growth, is I think you must have seen the recent stats from Gaidge that the overall number of starts has declined, but the production has grown. So the value per contract is is or the basket size is increasing. Some people are embracing retainer insurance programs or subscription programs like what retain offers. Some people are trying to go after other add on services like whitening or Botox that they can offer, along with orthodontic service to increase the basket size, but creating some kind of basket size increase either through the lifetime of the patient or at the time that they're going through treatment is kind of critical to critical to survive.

Some orthodontists have chosen the path of becoming like an airway or sleep specialist in working with expander devices that can potentially increase the basket size as well. Again, which path they choose is theirs. But they'll have to choose one thing. And I think the third big trend is. The irony of digital practices is that it.

It takes the equation. Earlier, your lab fees used to be the lowest expense 10%, and kind of puts you in the 20% bucket, depending on how big or small you are. So if you're spending 20% or one fifth of all your earnings and giving it away to labs, third party labs, no matter which the brand is, how do you then optimize the practice around that? So there's like an increasing focus on moving away from this value per visit fallacy to the profit per visit. Like reality and people who embrace the profit per visit reality will think of other ways to optimize it.

Like one technique is obviously a virtual monitoring. One technique is spacing out your appointments. Another technique is a strong focus on reducing your your comfort visits or emergency visits. So again, which path you take is yours. But unless there's a clear drive towards a profit per visit and you're just looking at the value per visit number.

I think the practice is going to not realize how much they're burning away in lab costs and overhead will keep rising. So in summary, one is like basket size increase. Second one is how to effectively capture the adult market away from your general dentists who are not helping them out. And the third one is how do you increase your profit per visit? And first of all, know what your profit per visit is.

Instead of waiting for the CPA to compile that at the quarterly level. So these three might are like things we've seen among successful practices, and which has also led to our success in the first year.

Anne Wemhoff: 34:34

That's all. I mean, that's awesome. You hit so many high notes there and I think, you know what, you you said it so well in the sense of like, you know, it's going to be different for everybody and what they choose and what path that they choose. So I think that's, that's really cool, really cool that you see that and that your product works within that, you know, looking ahead, what innovations are you most excited about in in the orthodontic industry and which practices be preparing for today?

Karthik Vinayagamoorthi: 35:08

We're really excited about very flow like our product launching next year, honestly. Very flow is like an entire clinical appointment with just your voice. So you speak into a microphone and it compiles all the subsequent actions thereafter. So it takes the burden away from the staff. You're working on the person's mouth, and then you're not going to work on the keyboard.

That's the goal. We're really excited about that. And we're also personally excited about our in-network contracting tool. So far, our contracting tool has only been working for our practices, but for in-network practices, there's like a lot of complications, especially since the amount of orthodontic coverage has declined year after year. Overall, across America, it's important that people maximize other kinds of insurance benefits, like dental benefits for intra oral exams and so on.

So our in-network contracting tool takes into account all those all that possibility to help doctors maximize insurance revenue without losing out. Even though the insurance coverage for orthodontics is reducing year after year. So we're personally excited about those two innovations from from very studio side, generally for the, for the like, what I'm excited to see about and how it flourishes in orthodontics is what's going to happen if more adults, adult patients, which is the only growing segment right now, if they start gravitating towards the general dentist and more orthodontics gets democratized among general dentists. There was one report by Gartner that said about 30% of orthodontics today amongst adults actually takes place in general dental offices and does not take place in orthodontic offices. So if you're the fastest growing segment is being taken away for for specialists, then how do specialists thrive and survive in like urban cities?

Of course, if you're in rural communities, there's nothing stopping you. Your shingle is going to call people. And I'm just really excited to see what's going to happen in that space. The other big question I have is right now, remote monitoring is as hot as AI is. Everybody, you know, thinking about how do we put patients on an observation program or a growth, some kind of guidance program, looking at them through a device at their home?

But I've lived in the medical device industry for a very long time. I worked on like diabetes and CGM devices. And one problem we had was like, especially when you launch a digital application where patients need to do something at home and there is an action involved, the compliance to those applications is far lower than the compliance to the drug that they have to take or the medication they have to take. So people are like, don't add more burden to my already existing treatment regimen. And if braces and Invisalign itself is such a routine needs to be compliant.

Now you're adding one more thing they have to comply with, right? You have to like now send us pictures to you have to now take these scans to how are how are consumers going to like, are they going to see it as burden homework? Or are they going to see it as like a pleasure of not coming and seeing the doctor every so often? So I'm really like curious and cautiously optimistic about really seeing how our patients react to remote monitoring as a phenomenon. And do they really see, I mean, we have so many sales pitches for this, but do they see the same value in it in a day to day circumstance when you're adding more burden to them at home?

It's almost like one more thing to do.

Anne Wemhoff: 38:42

I think it will be really interesting that because at one point it is really convenient. Right? I've already got I have three kids. And so getting to experience, you know, like a virtual visit for a specific doctor or whatever, and you're just like, hey, we're here. It's nice.

I mean, in a sense, but then it's like, okay, but do we still need that? It goes back to our conversation earlier, that human interaction piece. And like, sometimes it is like, hey, yes, I can really see, you know, what is happening in the mouth and the jaw and everything. And you can see that. Right, right.

You know, here in this space too. But I don't know, it's just that person to person piece, that human interaction piece. So I think it is going to be so interesting to watch and see where that area grows. So just a few more questions. What, what's one piece of advice that you would give an orthodontist who wants to future proof their practice over the next five years?

Nourah Kader: 39:41

Future proof the practice. It goes back to what I said about embracing technology in whatever means there is available to them. For example, like in our practice, even though we don't have voice charting in every studio yet, which we'll be bringing out later, we already have set up about that. We are too. And but in the meantime, we still want people to experience and learn what that is like at the smallest scale possible.

So every station in our office has a microphone connected to Perplexity. So they're just using Perplexity chatbot, which and just speaks into speaks into. It takes the note, copy paste them into the practice management system. And, and we got them. We're getting them used to doing that because eventually when we have one system where they start doing it, it's not new learning for everything.

And I, we talk about this to practices all the time where we say, don't wait for everything to be ready. Then it's going to be overwhelming and starting off with the easiest thing that would be the least disruptive to your practice? Some people are disruptors. You go in there and you flip everything, you know, 180 degrees overnight. That's Karthik and I, and our team is always surprised about what happened to our front desk.

We recently broke down our entire front desk and just kept a computer in the front and did it all over the weekend. But there can be practices that want to do it more slowly, because they want to make sure that the staff don't feel overwhelmed. So the biggest thing I would tell them is the future is coming, the future has AI in it, and the future is going to have a lot of, you know, these different voice charting technology built into it. And some of it, you know, not most of it, not all of it is going to be for your for your good, but most of it can be utilized to your benefit. So I would say start small, start somewhere that feels comfortable for you and make sure that you're injecting a little bit of that as you're growing so that you're not left behind.

Karthik Vinayagamoorthi: 41:35

I love that. Now one small thing.

Anne Wemhoff: 41:38

One small step every day gets you kind of up to that next level. I love that. So I have one last question for you. But before I ask it, I want to point people to your website, tell me what your website is so they know where to find you, and how to learn more about you. What's that website?

Karthik Vinayagamoorthi: 41:55

It's berrystudio.ai.

Anne Wemhoff: 41:59

Okay, berrystudio.ai. So here's that last question. What's one lesson that you guys have learned as entrepreneurs that has changed the way that you lead your company?

Karthik Vinayagamoorthi: 42:14

Yeah. One thing about Nourah and I, this is our third company that we're building together. And we have always told our teams from the very beginning that it's okay if this company does not do well financially, but we can if you go away from this place with a poor culture, that's that's our real loss. And we have a set of ten rules of what defines our culture. And we kind of reiterate that over and over and over again.

To the point that, you know, we have a quiz and they kind of compete with the quiz, they tell what our core values are, and they actually point it out when other people do not follow them. So I, I think, I think our we will still be happy. Quite honestly, if our company does not do well. But if everybody who leaves the company and finds another place, another home for themselves leaves with what they learned about the culture here and hopefully takes and makes it a better place. Personal story.

We don't have time to share that here, but she comes from a very, very disadvantaged background. She was the first woman in her family to go to college, and she obviously now is like thriving board certified orthodontist. But it took a long, long ways for her to come all the way here to the US and actually pursue her dreams. She had no financial support from her family and they were. She was the last amongst five kids.

So for her, what's really important is when a woman, especially a woman like gets empowered in this world, they should get empowered in a free, fair and just environment. So the kind of environment we have created at our practice and our like companies in the past and present is to focus on giving that kind of fair, equal patriarchy free growth opportunity for everybody involved and inculcating a patriarchy, patriarchy free culture is much harder in men, sorry. Much harder in women who have used to it or than men. So we are like big, big proponents of that.

Karthik Vinayagamoorthi: 44:27

I think it's the norm for sure.

Karthik Vinayagamoorthi: 44:29

Yeah, I'm saying a lot. But in summary, basically culture is all that matters.

Anne Wemhoff: 44:36

I love that. Well, you guys have been a joy. Your success in the last year has really been awesome to learn about today to see. I can't wait for January to come out with your new product. I just want to thank you guys.

Tell me one more time where can people find you?

Karthik Vinayagamoorthi: 44:55

berrystudio.ai.

Anne Wemhoff: 44:57

Okay, well, thank you guys so much for being on the show today, and I can't wait for our paths to cross in person. So I can meet you in person.

Nourah Kader: 45:07

Thank you so much.

Outro: 45:13

Thanks for listening to Straight Talk With EPIC4. We'll catch you next time. Be sure to subscribe so you don't miss future episodes.

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