Most orthodontists I know want happy patients and staff. This article is about how I, and scores of my colleagues, have used Internet communication technologies to help us satisfy our patients and reduce the stress on our staff. Communication is a mission-critical activity in orthodontics. We are not just engineering tooth movement; first and foremost, we are managing relationships. In a busy orthodontic practice, hundreds of communications take place every day: between doctor and patients, staff and patients, staff and responsible parties, and doctor and other professionals. Today’s “empowered” patients expect information about every aspect of their treatment, from clinical and appointment information to financial and insurance information. And today’s practice, becoming ever busier as a result of demographic trends, must be able to efficiently handle all of this information flow. About 20 years ago, computerization of the orthodontic office with specialized practice management software (PMS) made it possible to maintain the personal and financial records of many patients much more efficiently. About 10 years ago, digital imaging started to produce efficiency gains. Now we’re actually using systems that treat patients digitally. These technologies are designed to allow the doctor to manage information in digital form. Information in digital form is power: it is portable, transferable, and convertible. The information we collect about our patients is an invaluable asset. When that information is digital, we can store, manipulate, transmit, and convert it as we choose. Fairly primitive data conversion has been going on for years in our industry. If you have ever switched from 1 PMS program to another, you might have had your data converted—probably with many headaches and possibly with much reentering of data. When I purchased Orthotrac (Practiceworks, Atlanta, Ga) PMS for my office in 1994, I would have loved to have my old data converted but ended up entering everything by hand. I followed up with digital imaging several years later and took other measures to modernize my practice as well: a complete remodel with new equipment and a new computer network. But there was still a glaringly obvious efficiency gap in my operations: when my patients needed simple answers, they had to call my office. As in most practices, our phones are not answered evenings, weekends, and during lunch hours. Usually, patients just asked “when’s my next appointment,” “what has my insurance paid?” or “how did you split that credit card payment between my 2 kids?” All the answers were in my existing PMS database, and some of my front-office staff were spending much of their time fielding phone calls from patients, looking up information that was stored in that database. Historically, we orthodontists seemed resigned to hiring more receptionists and letting our patients get used to calling during the 7 or 8 hours a day the office was open and being put on hold. That was the way we’d always done things. It didn’t make sense. It was 1999. I knew that most of my patients had e-mail and regularly used the Internet. The Internet had already changed the way I managed my personal life. I traded stocks online, corresponded with my extended family online, went online for professional research, and, of course, shopped online. The Internet was saving me time in many ways. I wanted it to save time for my staff and patients, too. I had a nice Web site, but it just sat there—another pretty marketing brochure that happened to be on the Internet. My site got several dozen hits a month; I learned this is typical of orthodontic Web sites. People might go there once, but they didn’t return because there was no reason to—the site was static. I wanted my Web site to deliver answers to my patients. I teamed with a software company to create a system that would save my staff time and make it more convenient for my patients to obtain needed information any time of day without a phone call to us.