Our Blog

Try a “Virtual” Orthodontic Consult

You can get answers to all of your orthodontic questions from your home or office with a virtual consult.

You can even submit photos showing your concerns.  These photos are encrypted and uploaded to a HIPAA complaint server, the doctor will access these photos before you virtual appointment using a secure web application to share a screen and video chat.

If you would like to schedule virtual appointment to discuss your treatment option, please follow this link.  One of our team members will contact you and set a time for the consult and we will email you a link for the meeting.

Notice to all patients, family and friends

To our patients, friends, and family: We realize that the school and work closures are stressful on our community.   We are working to minimize risk of COVID-19 exposure to our patients and their family and friends.

If you or anyone you live with or are in contact with on a regular basis have significant underlying health conditions, you or your loved ones are at higher risk from COVID-19 and you should reschedule your orthodontic appointment.

The Mortality rate versus age is shown the the graph below.  These mortality rate reflect the higher incidence of co-morbidity in older populations.  Please consider your own health status and the health status of your loved one before deciding to keep your orthodontic appointment with us.


This chart shows the Mortality rate for different countries by age group. Please note the consistent trend of increasing rate with age when interpreting these data.

High risk individuals include:

Individuals over 60 years old, especially with underlying health issues or anyone with respiratory conditions.

Other health issues that indicate high risk status include:

Blood disorders (e.g., sickle cell disease or on blood thinners)
• Chronic kidney disease as defined by your doctor. Patient has been told
to avoid or reduce the dose of medications because kidney disease, or is
under treatment for kidney disease, including receiving dialysis
• Chronic liver disease as defined by your doctor. (e.g., cirrhosis, chronic
hepatitis) Patient has been told to avoid or reduce the dose of
medications because liver disease or is under treatment for liver
• Compromised immune system (immunosuppression) (e.g., seeing a
doctor for cancer and treatment such as chemotherapy or radiation,
received an organ or bone marrow transplant, taking high doses of
corticosteroids or other immunosuppressant medications, HIV or AIDS)
• Current or recent pregnancy in the last two weeks
• Endocrine disorders (e.g., diabetes mellitus)
• Metabolic disorders (such as inherited metabolic disorders and
mitochondrial disorders)
• Heart disease (such as congenital heart disease, congestive heart failure
and coronary artery disease)
• Lung disease including asthma or chronic obstructive pulmonary
disease (chronic bronchitis or emphysema) or other chronic conditions
associated with impaired lung function or that require home oxygen
• Neurological and neurologic and neurodevelopment
conditions [including disorders of the brain, spinal cord, peripheral
nerve, and muscle such as cerebral palsy, epilepsy (seizure disorders),
stroke, intellectual disability, moderate to severe developmental delay,
muscular dystrophy, or spinal cord injury].

If you are in a high risk or have high risk family members who are high risk and you have an orthodontic emergency, I will see you on a “one on one” basis to keep you comfortable and at the same time minimize risk of transmission.

It is likely that you will be contacted by our office to either move your appointment time or rescheduled to another day altogether.  We are doing this to minimize transmission risk for our patients.  We have opened additional days and times to see a smaller volume of patients and in some cases on a one to one basis.

Thanks in advance for your understanding and stay healthy….



Drs. Chris Riolo and Burcu Bayirli


Your safety is our highest priority

For the safety of our patients.  We are cancelling appointments for all patients 60 years old and older and those patients who live with high risk individuals.  If you are a higher risk patient, Dr Riolo will see you on a “One on One” basis for emergency appointments only.  We will continue this policy until at least April 1st and likely through the middle or end of April.

Each patient will be contacted by phone, text or email and screened before confirming their orthodontic appointment.

Who are higher risk patients?

Anyone 60 years and older as well as those individuals with an underlying health condition that increases the risk of death if they contract COVID-19.  You can find details regarding who is at increased risk from the COVID-19 virus here.

Those patients not at “higher risk” or living with higher risk individuals can if they choose keep their orthodontic appointment.  It is likely you will be contacted to move your appointment because we are modifying our schedule to minimize social contacts in our common  spaces.

What else are we doing in response to COVID-19?

Dr Riolo has a PhD in Epidemiology, specializing in infectious disease transmission.  We are monitoring the situation carefully and are continuously working to make your visit to our office among the safest destinations of your day.  We continue to follow all King county, State of Washington and CDC infection control procedures. In addition, due to COVID-19 we have made the following modifications to our infection mitigation procedures:

  • We are making extra sweeps through the office with medical grade surface disinfectant. 

  • We have modified our schedule to eliminate crowding in our common areas.

  • We are monitoring all of our staff for any symptom of illness, including daily temperature monitoring.

  • We are screening all of our patients for any signs of illness with a brief questionnaire at each visit.

  • We are working to identify “high risk” individuals and those patients that are in close contact with high risk individuals in order to reschedule or see these patient “one on one” if necessary.   You can find information regard who is at “higher risk” at our recent blog post here

Please notify us if you have been sick in the last two weeks or have had contact with someone who has been sick in the last two weeks. You will not have to wait an extended period for a new appointment if you reschedule your appointment due to illness or suspected contact with someone exposed to COVID-19 . We will reschedule your appointment to reflect a  2 week waiting period

We are monitoring the local situation carefully and are confident that a visit to our office is one of the safest of your daily activities.  We will continue to monitor the situation continuously and take additional steps as necessary to keep all of our patients and their family and friends safe.

Digital technology provides opportunities to add value to the care orthodontists offer their patients

Innovations in technology are disrupting the orthodontic profession.  These changes affect both orthodontic care delivery and the economics of care delivery – the orthodontic marketplace.  “Disruptive Innovation in healthcare involves technologies, products, or services that are cheaper, simpler, and more convenient, making it possible for less-expensive professionals to provide advanced services in affordable settings, or even for patients to care for themselves.”1,2.  This is not the first time that the orthodontic profession has experiences disruptive innovation.  Consider the advent of the direct bonded appliance or the straight wire appliance in the 1970’s. Orthodontists at the time where concerned that these changes in technology would result in an increase in the number of general dentists and pediatric dentist doing orthodontics. In reality, these advances in technology provided benefits to patients and the orthodontic profession as a whole. Consider the advent of Invisalign in 1999;  orthodontists at the time were again concerned that general dentist would now treat more orthodontic patients. It is true that dentist have treated more orthodontic patients since the introduction of Invisalign, but so have orthodontist!. In fact the “orthodontic Pie” has increased in size and both general dentists and orthodontist are providing more orthodontics treatment. In fact, Invisalign through their enormous advertising budget is probably responsible for the aesthetic adult orthodontic market that all of us enjoy today.    Digital technology is making custom orthodontic appliances like Clear aligners possible. Today we are experiencing disruption of the orthodontic marketplace through the “direct to patient care” model through corporations such as Smile Direct Club, Candid Co, Byte, etc. due to the advent of custom orthodontic appliances. The same digital technology that makes this corporate direct to patient care model possible offer us as orthodontists real opportunities to improve the care we offer our patients. There are primary advantages that digital technology offers orthodontist to improve the care they offer their patients. 1) Proactive Treatment Planning, 2) the use of custom orthodontic appliances coordinated on a unified digital platform and 3) using 3D printing to take control of our workflow to provide our patients true customization at a minimum cost.  We will be expanded on each of these three points in subsequent blog posts.


1  https://innovations.ahrq.gov/perspectives/harnessing-disruptive-innovation-health-care
2 Will Disruptive Innovations Cure Health Care. Christensen C., Bohmer R, Kenagy J. Harvard Business Review. Sept-Oct 2000