Living the American Dream and Launching OrthoNu with Dr. Sima Yakoby Epstein

Luke Shapiro, DDS

Dr. Sima Yakoby Epstein is a first-generation American. Her family is from Georgia, a country located in Eastern Europe and West Asia. She grew up in a very disciplined, traditional, and loving home and was raised on ethics, hard work, and living the American dream. Her dad was a taxi driver who grew his own fleet to over 60 medallions. She completed dental school at UPenn, and after practicing cosmetic dentistry for a couple of years, returned to UPenn to become an orthodontist. She practiced in New York City for about 8 years with Lemchen Salzer Orthodontics.

When Did You Create OrthoNu?

The concept for OrthoNu started to evolve in November 2020. As an orthodontist, I felt a real disconnect between doctors and patients after they left the office. There was really nothing in that goodie bag that was helping patients sustain their health and well-being throughout those two to three years of treatment. When COVID hit, orthodontists were faced with managing a lot of stress and anxiety, as well as fielding emergencies from friends and even people we didn’t know. It was frustrating that we didn’t have a proper tool to give our patients in the event of an orthodontic issue. Our best solution for orthodontic emergencies was to use a dirty toenail clipper or a plier that could cause more problems than solutions.

I wanted a better choice, so in my basement, I started devising what would become Tweakz. I would look over at my husband, who is also an orthodontist, and ask, “What else do we need?” And I just kept adding tools to this little tool that resembled a Swiss army knife. After creating one for braces, we also realized the need for one for aligner patients. So far, I have created 18 products in the OrthoNu pipeline.

How Did you Come Up With The Name OrthoNu? 

Growing up in Georgian culture, there’s a slang word that everyone always uses at the end of a conversation - “nu.”I also thought that if you look at the letters N and U together in a creative way, it looks like an infinity sign.

And Did The Name Come To You Instantly, Or Did You Add Various Iterations Before?

We had many iterations, like “BocaNu” because I loved to go to Boca, Florida, and I loved the Spanish connection since “Boca” means mouth. But “OrthoNu” connected the tool with our profession and just felt right.

As For The Product, Did You Test It With Friends And Family Or Colleagues? What Was That Process Like?

Testing with family was pretty easy because we have multiple orthodontists in the family. As for colleagues, at the time, I called my friend/colleague from the UK, Dr. Anton Bass. I also called many of my school friends at Penn and introduced them to Tweakz on a Zoom call. Everyone’s reaction was the same — “This is so cool. I can’t believe this wasn’t developed before.”

What Would You Say Is Like The Most Difficult Part Of Running The Business?

The word “difficult” no longer exists in my vocabulary. Challenges are a reality every day. And for me, being an orthodontist and dealing with patients and moms, I have discovered my “superhero talent” of compassion and being able to be kind, loving, and sensitive to everyone and empathize with what they are going through. For me, becoming an entrepreneur was challenging because the skill sets that I am naturally, and instinctively good at are not what makes an effective entrepreneur in the real world. For instance, marketing — finding the right company, determining the budget, and reaching the consumer — some of those skills I am learning through experience.

I also found out that manufacturing is a whole different world from orthodontics. It’s complicated trying to find and choose the best manufacturer for your product because people all over the world approach processes differently. First and foremost, I was focused on the quality of Tweakz. The quality that I was looking for was not enough with the first two manufacturers I tried, and I had to continue my search through two more. There’s just so much learning involved as an entrepreneur, and I have learned more in these last two years about so many things than I could ever possibly imagine. It’s becoming easier! I have come to expect that I will not know everything. I expect to make mistakes, and I expect to pivot.

I just keep reading, learning, asking questions, and surrounding myself with people who have developed successful businesses, and I soak up their knowledge like a sponge. I stay humble, keep my head down, and just fight through the problems every day. Whatever comes up, I just get it done.

Do You Have Any Patents?

We have over 18 patents pending and already have three that were allowed. I patent every concept I possibly can because they are all cool ideas, and since no one has really done these things before, I thought it was really important to get the patents. It has been a very long and expensive process.

Where Have You Had The Most Success With Sharing The Orthonu Products?

First, certain orthodontists have been extremely kind and compassionate in the OrthoNu journey for me and have been really positive role models in supporting OrthoNu. Secondly, I love going to conferences and watching people see Tweakz firsthand, touching and feeling it, cutting the 19 x 25 steel wires, and having it hold the little cut piece firmly, preventing that piece from falling into the patient’s mouth. They’re excited about that. They think it’s really cool. The doctors in Paris and the EU loved it!

Another step forward is the doctors who already have adopted this into their standard of care. They have said, this is going to be incorporated into their treatment fee, and every new patient, whether in braces or liners, will get a Tweakz.

What Do You Think Makes An Orthodontist Choose To Make This Part Of Their Standard Of Care? 

I think it really depends on the type of practice and geographic location. For example, Dr. Paolo in Napoli told us that, basically, some patients have to travel in two hours of traffic to get to his office daily. And he said patients complain that when they finally get to his office, he’s basically seeing them for like two minutes. They feel that it’s a waste of their day to have to travel so many hours and skip school or miss work. Chris Benson is currently writing a white paper, and other people like Dr. David Sarver and the Clinician’s Report are doing their own surveys to really make people understand how beneficial Tweakz is and the net savings it brings per year for each office in unnecessary appointments. It really comes down to the numbers for orthodontists.

Also, if you offer a patient a Tweakz that has your office logo on it, students will carry it around in school, and the moms will pull it out at work and travel with it. That is marketing in real life.

Do You Have Any Advice For Budding Entrepreneurs?

You’d be surprised how many people are willing to talk to you, help, and give you their advice. And so I think I would start by reaching out, perhaps, to a teacher or a mentor that you had a connection with at school to potentially support or guide you.

I think it’s important to find a mentor who will guide you through the process. I didn’t have a mentor in the beginning. I called my brothers and similar orthodontists and asked for help. Through the industry, I found a great mentor who has really helped me and taught me so much about this business.

And lastly, in terms of making the decision to become an entrepreneur, I think the decision is made for you long before you even realize it. It really is about feeling like you have a need to accomplish a certain goal. And it’s so strong that nothing really stops you.

Dr. Lucas Shapiro is a graduate of Washington University in St. Louis and Stony Brook University School of Dental Medicine, where he received his Doctor of Dental Surgery. He completed his post-doctoral orthodontic training at Tufts University School of Dental Medicine. He currently practices orthodontics at Lemchen Salzer Ortho in NYC. He started the Instagram page @futuredentists, works with the educational organization @ ignitedds, and has an orthodontic tiktok page @drshap.