Ep 57 - How Smiles Change Lives Helps Children By Donating Braces

March 05, 2024

What can be said to a patient who cannot afford braces due to financial constraints within their family? Fortunately, there are resources available to help. On today's episode, we'll introduce you to Smiles Change Lives, a non-profit organization dedicated to making braces accessible to children. For 27 years, Smiles Change Lives has helped countless children achieve healthy, beautiful smiles.

Vice President of Operations, Alexis Barclay, will delve into the program's details and explain how you can apply. We will also hear from Dr. Victoria Lynskey, an orthodontist with a decade of experience working with Smiles Change Lives. She'll share heartwarming stories about the program's impact and the joy of transforming a child's life through the gift of braces. Tune in and discover how Smiles Change Lives can bring a brighter future to children in need.


  • (0:00) Dr. Leon sets up the scenario of a boy needing braces and a family who cannot afford them
  • (5:10) Alexis explains how Smiles Change Lives is different than other nonprofits in this space
  • (6:52) Alexis shares his music background playing electric bass in Kansas City
  • (8:08) Alexis describes how they vet families to be eligible for Smiles Change Lives and how they help when they do not qualify
  • (10:47) Alexis talks about the progression of qualifications for Smiles Changes Lives
  • (13:47) Discussion of how the orthodontist participates in the program
  • (15:22) Dr. Victoria Lynsky shares her positive experiences with Smiles Change Lives
  • (18:01) The process of signing up with Smiles Change Lives
  • (20:59) Alexis discusses what he sees in the future for Smiles Change Lives


  • (4:53) Smiles Change Lives has been in business for 27 years, and during that time, they have learned what not to do, let alone everything to do to support their providers and their patients
  • (7:49) There is a strategy Smiles Change Lives uses to work with families who can’t financially afford braces. It begins with reviewing tax returns 
  • (10:26) The completion rate of successful orthodontic work is 99% when the patient pays something out of pocket. It also provides leverage for the parent who pays the bill but empowers them, knowing they did this for their child.


What follows is an AI-generated transcript. The transcript may contain errors and is not a substitute for watching the video.

(00:00:00) Dr. Leon Klempner: Let me know if you could relate to this. You're going in for a consult. You meet the mom. Very sweet. Very nice. And the patient 15 year old boy sitting there kind of head down. Uh, you do an exam severe case, teeth all over the place. Mom tells you that, you know. Uh, her son doesn't have many friends. He's very embarrassed about his smile.

A lot of psychosocial issues relating to his teeth. Uh, it doesn't have many friends. You really want to treat this case because you feel you could really change this kid's life. Uh, so you, you leave the room, uh, your TC speaks with them and then they leave without an appointment. Uh, finances are the issue.

How does that make you feel? I could tell you when that happened to me, I had a pit in my stomach. However, you know, I've treated cases for free in the past and my experience has (00:01:00) been that many times when they do that and the patient has no skin in the game and hasn't paid anything, there's a lot of no shows, a lot of broken appliances.

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Join your host Dr. Leon Klempner and Amy Epstein each month as they bring you insights, tips, and guest interviews focused on helping you capitalize on the opportunities for practice growth. And now welcome to the golden age of orthodontics, with (00:03:00) the co founders of people and practice, Dr. Leon Klempner and Amy Epstein.

(00:03:07) Dr. Leon Klempner: Welcome to the Golden Age of Orthodontics. I'm Leon Klempner, retired board certified orthodontist, proud board certified, director of orthodontics at Mount Sinai Hospital, part time faculty at Harvard, CEO of People in Practice, and father of three children. Bright, intelligent, compassionate women. One of which is my cohost, Amy.

(00:03:30) Amy Epstein: Let's see when you change it up month on month like this and you thank you. I'll just say thank you for that lovely internet introduction, dad. I'm Amy Epstein. I have a, an MBA in marketing and 20 years of public relations experience. And we started people in practice together, um, so that we could bring the tenants of multinational brand marketing.

To the business of orthodontics today, we're delighted to welcome to the podcast, Alexis (00:04:00) Barclay, who's vice president of operations at smiles, change lives. This nonprofit is dedicated to helping provide orthodontic care to children, whose families lack the financial means to afford braces. So Alexis was raised across the pond in North London and he joined smiles, change lives and has served as director of provider services for 11 years before becoming the VP of operations.

Transcripts provided While he is not at work, you can find him playing bass with one of Kansas City's notable bands. We'll ask him which one so we can follow it. He resides in Riverside, Missouri with his wife, Brooklyn, and their three kids. Welcome to the podcast. Thank you so much for joining us today.

(00:04:39) Alexis Barclay: Thank you so much for having me. This is all, this is nice. A nice little warm bath right here. I love it. I love it. 

(00:04:46) Amy Epstein: We aim to please. Well, thank you very much again. So let's talk about Smiles Change Lives a bit. Um. Tell us a little bit about how Smiles Change Lives changes lives is different from (00:05:00) other nonprofits in the space because our clients, you know, they often partner with organizations, but we want to understand specifically what makes it a little bit different.

(00:05:10) Alexis Barclay: Yeah, sure. So, I mean, Small Strange Lives, first and foremost, I believe we're with the oldest access to care program as far as orthodontics are concerned. Uh, when we started 20, 27 years ago, uh, we were working with UMKC School of Dentistry, um, and To be honest, the difference would be that we have done it for such a long time that we figured out all the ways not to do it.

Dr. Klempner kind of touched on a couple of things that doctors look for, practices look for, uh, along the lines of, um, and we can get into it a little bit more obviously, but the, the, the no value in three. Kind of aspect of things. Well, we started that to a certain extent and we worked with a lot of wonderful orthodontists and student orthodontists, resident orthodontists, um, to see, (00:06:00) you know, who can we help, how can we help them and what the responses and through that, we went through a lot of.

Changes. We worked a lot with, with our orthodontists figuring out what the best thing for the practices are. Um, and we continue to do that. We are very orthocentric. We do not. We want to make sure that we are doing the best by our providers because the bottom line is without our providers, we can't. Do what we do.

Um, and I would say that's the biggest difference, purely our longevity has kept us where we are and it's directed us in the right, in the right directions. 

(00:06:36) Dr. Leon Klempner: So, um, Alexis, first of all. You play the bass. Now, is that a string bass? Is that the electric bass? Is it, what kind of band is it? It's an orchestra.

Just give us like a little bit so that you don't leave us hanging. He's prioritizing the question of this conversation. 

(00:06:51) Alexis Barclay: Yeah, I got to know that. No, hey, you know, I'll talk music all day for sure. Um, yeah, so I'm a, I'm an electric bass player. I am a, I do play some standup as well. (00:07:00) Um, I like to play with all sorts of different bands, everything from jazz, blues, obviously Kansas City is a great, uh, Music scene as far as that's concerned, I do play in a rock band and I also play in an Irish folk band as well, so I, I keep my options open depending on, uh, depending on what it is.

As you can see from my teacup here, I'm a big, big Beatles fan. So that's, uh, That's, uh, one of my bigger, bigger influences right there. 

(00:07:25) Dr. Leon Klempner: I said, do you want to give a shout out to the rock band to people follow, or you want to keep it under the cover? 

(00:07:30) Alexis Barclay: Oh, sure. Yeah. The name of the band is, uh, you can, you'll like this if you're, if you're a science mind with a super massive black holes, it's the name of my band.

It's a little bit different to the way I look right now, but, uh, you know, always having a good time. So, 

(00:07:45) Dr. Leon Klempner: so. Tell me this. Um, I have a kid that's in my practice that doesn't have the money. Um, how do I know? How do you know he doesn't have the money? Like, what is the (00:08:00) process of how you would vet out a patient that would be a good candidate for 

(00:08:06) Alexis Barclay: the program?

Yeah. So, I mean, and that's, it's, it's the best question, right? Because I think there's an idea that even, even when people come in, are they pulling at your heartstrings? Are they actually telling you the true story? Unfortunately, that is something we have to look into, especially when it comes down to, to doctor's time.

Um, so one of the big things that we do is we check their tax returns. Um, we look for families, 200 percent or below the poverty line. Um, and then depending on which area they're in as well, we do look at cost of living. Um, since the world is just a different place, uh, since when we started 27 years ago, it was pretty easy to kind of stay black and white in between certain regulations.

Well, um, you know, things, things just aren't the same way. The difference between Kansas City and New (00:09:00) York City, uh, is significant. So we do look into those things. We'd look into where. Uh, the family lives, we look at Zillow prices, things of that nature. And if there's any question, then we will, we will have in person interviews with the, with the patients to make sure that we're getting everything we need.

My biggest job, our biggest job is to make sure that we are not wasting your time with someone that could pay otherwise. Um, and in fact, most people that are looking for smiles, change lives as, as, as a need are just thankful. To, to, to get something and if, and if, if they are not within our guidelines, they will reach out to me and ask, can you find me an affordable orthodontist?

Is there someone with a payment plan? I think there's a lot of people out there that are just scared to make the first step and be vulnerable. Um, and not understand that there's a, you know, there's hundreds of, if not thousands of orthodontists out there that will, (00:10:00) will help them. Um, and so we come in and we help the people that are hardworking, um, that, that just, that just can't get that hand up.

And so that's, that's what we look for and it's very much a partnership with our, our practices. I, I do not obligate our doctors to do something that they. What to do sounds obvious, but, um, but, uh, it's, it's, it's something that's significant to say. 

(00:10:26) Amy Epstein: So you talked a little bit about the, you know, um, the challenges of having patients that, um, you know, don't have skin in the game showing up.

Dad and, you know, so how does smiles change lives model, um, you know, avoid that situation? 

(00:10:47) Alexis Barclay: Yeah. So we, we, when we started, it was zero dollars. In fact, we had the doctors pay into our program to be a part of our program. Um, and you, It (00:11:00) wasn't a bad idea, but it was just, it wasn't the way to move forward. It was a lot more obvious to us after, um, not having the patients have us have skin in the game to, to have them do that.

Um, and so we, we went on a sliding scale up to, and where we, where we ended up with 650 is what their families pay in. Um, and we, we changed it to that in 2012 and we haven't changed it since. Um, the reason for that is it runs right about 10 percent of the national. Average of a class two orthodontic treatment, depending on who you go to.

Um, but, uh, we wanted to make sure that that skin in the game, it, it, it empowers the parents. And what we have found is when we were charging zero, um, we were looking at about a 50 to 60% completion rate. We went to $250, we went to $500, and then we went to $650. And at $650 we were at ni over 99% completion rate.

So (00:12:00) that, that unto itself kind of tells the story. Um, but it did come with a lot of heartache. It did come with a lot of questioning. It did come with a lot of, you know, what are you trying to do here? Who are we trying to help? All of those kinds of things. Um, but the bottom line is I believe that for the majority of people, it is a, uh, It's a price point that is, that can be done.

Um, and it's also something that will get them to their appointments when they need to, as, as you know, you know, better than I do, there's nothing worse than waiting on an appointment that never shows. Um, and we certainly don't want to be a part of that because what we have to keep in front of us is if it seems like a waste of the doctor's time.

Then why are they going to come back and treat more kids? Um, and so we want to make sure that this is a good situation for everyone involved. Obviously, the child getting a life changing smile, the parents being empowered by being able to actually pay for it. Um, and then, you know, the doctor and their staff to be able to be happy (00:13:00) that they're treating someone that actually deserves it.

(00:13:02) Dr. Leon Klempner: One more quick follow up question. How does it work? For the orthodontist. I mean, are they donating everything? Uh, do you help them out in any way? How exactly does it work? 

(00:13:14) Alexis Barclay: Yeah. So the big thing is we want is your time. Um, and I know that's the most important part of things and the most, uh, the most expensive things.

So, uh, one thing that we do is we work with American orthodontics. We work with the law orthodontics, um, and a handful of other vendors that will help, uh, donate brackets wires. Uh, we are working with a few aligner companies also, um, as well as retainer companies to Bye. Bye. Bye. to curb those costs, depending on we, you know, obviously every doctor kind of has a different system that they like to use.

But, um, I am very good at calling these companies and making sure that they will donate. And the biggest thing is to try and work as a team. And, um, it's, it's very heartening to me that, you know, when the (00:14:00) doctor was involved, when the staff's involved, that the orthodontic vendor, um, You know, it's, you know, it's, it's, it's good for them to be involved too, you know?

And so then all of a sudden we've, all of us are coming together to help the kids smile. Um, and the, the only other thing I'll say about that also is when it comes to time, um, part of the smiles change lives, um, process is that some of these families will understand that they will be scheduled at low peak hours.

Um, so, you know, we, what You know, with all due respect to them, we want to make sure that they're getting treatment, but we also aren't trying to take paying patients out of a doctor's chair, um, which is again something we learned over the years. Um, and that's not, they're still getting high quality of care and, and all of that good stuff.

So we just want to make sure it's, we, we want to manage everyone's expectations beforehand. (00:15:00) 

(00:15:00) Amy Epstein: So, you know, we actually know about smiles change lives because one of our clients, Dr. Victoria Linsky, who's out in Santa Rosa, um, use the use of smiles or partners with smiles change lives to provide this type of care to some of her patients.

And we invited her to talk a little bit about her experience with smiles change lives. 

(00:15:22) Guest Question: So I've been involved with smiles change lives. I'm going to say like 10 years, I'm sure. Melanie can go back and find out when I started as a provider, but I'm going to say like 10 years ago. Um, and I just did it because, you know, I was, I'm an immigrant.

I came to this country. My parents didn't have any money. I had a dentist do my orthodontics. And so when I heard about this at some meeting somewhere, I'm sure something was laid on the table. With Smiles Change Lives, what they like kind of hit all of the things that were, that mattered to me as a provider.

So number one, They took that screening away from me so that, you know, somebody, and, and (00:16:00) oftentimes I'll have a patient that will come into my office and they're just, I can tell, like, we know, like, we've figured it out. Like they're never going to be able to afford this. We had a lot of people from a community clinic, a lot of people that would not normally be able to afford this.

And we actually direct them to smile, change lives website because I screen them. And I already know. They need it. And I can tell they're, they're going to hit that poverty level. Um, and so it's kind of like the backdoor in, they go through the application process. Small change lives tells me, Hey, you know, these two patients, can you take them?

And so I, back in the day, just decided I was going to take six. I don't know where the number came from, but I just said, I'll do six a year. Big deal. We're talking a couple of, you know, Okay. How many appointments is that? Like, it's not, it's not huge. I'm not maxed out on chair time. Um, and I have a fully, you know, a team to office, like.

To me, as a provider, having another person in the chair doesn't (00:17:00) doesn't make a big deal. However, when you look at the overhead, small change lives actually sends me a set of brackets and wires and I can also get retainers through their, through their, um, their contacts. And so. You know, to me, if I'm a provider and I'm struggling, I'm like, I don't want to spend the whatever dollars on hard product.

I just do what I do best, which is, you know, enjoy changing smiles. And then at the end, I have somebody who is incredibly grateful for the opportunity to be able to have braces. Um, they were so thankful about not getting bullied anymore and the excitement of having a new smile. So that. I mean, I'm selfish because that warms my heart more than, you know, a paycheck.

So, um, so to me, it's kind of like, I'm giving back to my community. So that 

(00:17:51) Dr. Leon Klempner: was, that was great. And it's, it's nice to hear from somebody that's actually participating in partnering with you, so. (00:18:00) Talk about partnering. So let's say one of our listeners or many of our listeners want to engage with you and want to, uh, sign up.

Like what's the process. Could you just speak a little bit about how it would work, um, so that they could get 

(00:18:17) Alexis Barclay: going. Absolutely. Yes. And yes, all the listeners. Let's, let's, let's do it that way. Yeah. So, um, One of the things we like to do is make it as simple as humanly possible because everything else in life seems to be the most difficult thing and very, very complicated.

So as far as the sign up is concerned, there's a lot of information obviously at our website, www. smileschangelives. org. Um, and for all those is the tab you're looking for outside, outside of that, you can always contact me. Um, and I'm sure we can, uh, we'll get that information out there. Um, there's a provider agreement that basically just asks who you are, where you are.(00:19:00) 

Who are the best contacts? When's the best time of the year to find, uh, for us to send, uh, kiddos? Um, because everyone's a little bit different. You know, if you're in the South, it's different to the North. If you're in the West, it's different to the East. Um, what kind of hardware do you use? What kind of software do you use?

Those kinds of things. Where did you go to school? Um, And at that point, I do a quick orientation, uh, which takes about 10, 15 minutes, which just kind of speaks to the process, um, what to look for, um, you know, what's a good candidate. Some things that maybe you've not thought about when it comes to a good candidate or even a bad candidate.

Um, and just kind of get that, that partnership really moving in a, in a good direction to where, um, we're all on the same page. And again, we're looking for the best of the best here. We're looking, we're looking to make sure that this is going to help. Rather than hinder and it's certainly not going to obligate.

That's one of the big things over the (00:20:00) years. I've had conversations where it's, it's not doing this for smiles, change lives. This is doing, doing it for us and our souls. Uh, this is, this is us, you know, this is us trying to get some heart and smiles out there. So that's, you know, that's as quickly as it takes.

Um, all in all, there's a little bit, like I say, there's one, one sheet of paperwork. And, and you have to listen to me drone on for about 15 minutes, but outside of that, it's, uh, um, I'm always there as a, as, as my team is to help however we can. 

(00:20:32) Amy Epstein: That's great. So, um, you talked about some process improvements that you've made over time.

And the fact that smiles change lives is really distinguished by the fact that you really do know what the best. Program looks like based on the data you've collected over time. So are there, is there anything on the horizon, uh, process improvements or new things that you could talk about with smiles change lives?

That's upcoming. 

(00:20:59) Alexis Barclay: (00:21:00) Yeah, uh, always, um, it always feels like we're working on something. And, and what I've found is that the, that it's, it's a lot of it is about timing. Um, and I feel like 2024 is there's a, there's a little bit of a, uh, uh, rebirth kind of new, there's, there's a different vibe in the air. And so that's very exciting to us.

One of the things that again, like I touched on this earlier. Is we like to get feedback from everyone, whether it's good or bad, um, you know, tell us, tell us why, tell us why not. Um, and so one of the big things we're trying to put together now is an advisory board. Um, with orthodontic professionals, everyone from doctors to office managers, to TCs, to marketing, to people that are working for orthodontic vendors.

Um. Because the bottom line is, it's not just, this is, this is the big thing, this is not, this is not Smiles Change Lives, this is about putting a culture out there, (00:22:00) where, um, it should be very obvious and very easy for every orthodontist out there to be able to help. And, just like the families not being able to walk into an office, it's the same thing on the other side, where a doctor says, hey, how can I help?

Well, let's make it easy for them. Um, and let's have everyone talk about it. There's nothing better than, especially in this day and age than getting a kid out there smiling. So, um, so that's one of the big things. And we're also, we're doing that similarly with an orthodontic also only advisory board as well.

Um. So again, the one, the one thing I will always say is we're not orthodontists. We are not here trying to, uh, define what an open bite is and all of those kinds of things. That's what we, you know, that's where our partnership comes in on. And so figuring out again, Where the best kids are coming from, what's the, you know, geographical surroundings, things like that.

Um, so those are two very exciting things. (00:23:00) Uh, we are looking to the AAO to have a couple of events out there. Um, and so we can learn more about each other, but the big thing is just like everything else in life, it's, it's very much about communication and anything that we can do to communicate better, um, that is, that's really our key, so that's, that's what we're looking to do.

(00:23:21) Amy Epstein: That's great. Well, we look forward to seeing you at the AAO. We'll be there as well. We'll have a booth and we're giving a little talk. So, uh, we'll swing by. Yeah. Well, uh, we'll, we'll learn more about you and, um, yeah, hope to continue the conversation. So tell us how our listeners can get in touch with you if they'd like to learn more about Smiles Change Lives or, or specifically ask you some 

(00:23:44) Alexis Barclay: questions.

Sure. Yeah. And you can get ahold of me at any time. Um, So again, website www. smileschangelives. org. Uh, my direct email is alexis, A L E X I S at smileschangelives. org. (00:24:00) And that's smiles, plural change, singular lives, plural, um, done this a few times.

My name's Alexis for crying out loud. I mean, the amount of times I get Alex and all sorts of stuff. So, um, and then my, my, my, my telephone is always open. So you can always get ahold of me at 8 1 6 7 8 6 3 3 0 9. And I'm always happy to talk about it. This is a, this is a passion project for everyone. And, and I'm happy to talk about how we can make people happy.

(00:24:33) Amy Epstein: Wonderful. Well, thank you so much for joining us today. Really appreciate you taking the time. And, um, I hope our listeners will reach out to you and ask some more questions and get involved in, um, you know, contributing their knowledge and experience towards charitable pursuits. So thank you again for joining us and we'll see you in early May.


(00:24:53) Alexis Barclay: Thank you so much. 

(00:24:55) Amy Epstein: You can subscribe or download other episodes of (00:25:00) our podcast on Apple Podcasts, Spotify, SoundCloud, YouTube, if you want to see us or wherever you get your podcasts. And if you enjoyed it, we'd appreciate you telling a colleague. 

(00:25:11) Dr. Leon Klempner: Lexis, thanks again. And I'm going to go, I'm going to see if I can find you on YouTube or whatever, because I'm 

(00:25:18) Alexis Barclay: black holes.

You got it. Absolutely. I'm on Spotify and everything. 

(00:25:23) Dr. Leon Klempner: All right. Good to hear it. Uh, I want to thank our, uh, everybody for watching or listening to our podcast. We really appreciate you taking time with us. Um, we're, we're all really blessed to be in a profession that enables us to change lives and make good money.

And have fun while we're doing it. So this is really an opportunity for us to give back. I hope you'll consider joining. And remember, it's never been a better time to be an orthodontist. See you next time. 

(00:25:55) Narrator: Thank you for tuning in to the Golden Age of Orthodontics. Subscribe now on Apple (00:26:00) Podcasts, Spotify, or visit our website at thegoldenageoforthodontics.com for direct links to both the audio and video versions of this episode.

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