When to Treat In-House vs Refer
Fast Guide
- Good GP in-house
- Consider co-manage
- Refer to ortho
Use clinical judgment and patient preference. When in doubt, Elite will review records and advise within 24–48 hours.
Clinical Scenarios
| Scenario | Examples | Recommendation |
| Mild crowding / spacing | ≤3 mm per arch, minor rotations, anterior esthetics only | In-house. Limited aligners with clear goals & retention plan. |
| Pre-restorative alignment | Uprighting for implant/bridge, minor alignment before veneers | In-house or Co-manage for movement planning. |
| Anterior crossbite (single tooth) | No skeletal discrepancy; good posterior support | In-house or Co-manage for predictability. |
| Relapse cases | Lost retainer; previously completed comprehensive treatment | In-house when movements are small & documented. |
| Moderate crowding/spacing | ≈4–6 mm per arch, multiple rotations | Co-manage or Refer depending on anchorage/control needs. |
| Class II / Class III patterns | Sagittal skeletal or dental base discrepancy | Refer (growth guidance, mechanics, or surgery planning). |
| Open bite / Deep bite (>2 mm) | Vertical problems, tongue posture, habits | Refer for comprehensive planning and stability. |
| Crossbites / Expansion | Posterior crossbite, transverse deficiency, RME/SARPE | Refer (growth vs. adult strategies). |
| Impactions / Ectopic eruption | Palatal canines, traction, exposure | Refer (interdisciplinary timing with OS/Perio). |
| Periodontal/ABF risk | Fenestrations, recession risk, reduced periodontium | Refer (light forces, sequencing with Perio). |
| Airway / TMD / Complex habits | Mouth breathing, bruxism, parafunction, pain | Refer (multidisciplinary care). |
Great In-House Wins
Fast, predictable, profitable cases:
- Limited aligners: anterior alignment, small diastema, minor rotations, clear retention plan.
- Pre-prosthetic setup: molar uprighting, space redistribution, minor intrusion/extrusion.
- Relapse refinement: short-course aligners after retainer loss, quick retention refresh.
Refer to Orthodontist When You See…
- Growth & Skeletal: Class II/III, open/deep bite > 2 mm, transverse deficiency.
- Complexity & Control: moderate–severe crowding, impactions, heavy anchorage cases.
- Biologic Risk: reduced periodontium, recession, fenestrations, poor oral hygiene.
Optional Co-Management Support
Use when you want a second opinion; otherwise manage in-house.
Step 1: Share records (photos, pano/CBCT, goals).
Step 2: Receive a 1–2 day treatment outline or referral recommendation.
Step 3: Chair-time ROI – keep predictable cases.
Step 4: Shared follow-up; Elite handles refinements or complex mechanics.
Co-Management Review Options
| Service | Description | Fee |
| Ortho Case Review | 24–48 hr turnaround; candidacy, objectives, IPR & retention idea | $299 |
| Ortho Case Blueprint | Deeper plan with attachment map & staging detail | $399 |
| Live Co-Plan | 30-min video consult with follow-up note | $150 |
Notes: Advisory only; GP remains treating doctor. No fee-splitting. If patient starts comprehensive care at Elite within 60 days, review fee may be credited to the patient.
Why General Dentists Choose Elite Orthodontics
- Consults offered within 48 hours.
- Optional case reviews/blueprints for GP-managed cases.
- Works with Invisalign, Angel, and Spark.
- Clear co-branded communication.
- Conservative, perio-conscious, stability-focused care.
How to Refer
Digital Referral: Complete the form below.
Call or Email:
14300 Gallant Fox Ln #112, Bowie MD 20715
(301) 262-8500
eliteorthogroup.com
Elite can review case photos and goals within 24–48 hours.
Elite Orthodontics – Partnering with General Practitioners for predictable, profitable outcomes.
© 2025 Elite Orthodontics. One-page clinical and marketing handout.
Patient Referral Form
Please complete the form below and upload any pano/ceph images.