Dr. Dean C. BellaviaThe Bio-Engineering Co.
Changing Face of Orthodontics, Part-I (braces)
Do you appreciate how much orthodontics has evolved over the past 50 years? You should! Are you aware of the latest trend of self-manufacturing your brackets and aligners in your own office? Maybe this pearl can help you put the pros and cons of the changing face of orthodontics into prospective.
Over the 50 years that I’ve been organizing orthodontic practices there has been many changes, some pros and some cons; nothing comes without a price tag. In Part-I of this three-part series we will discuss the pros and cons of the changing face of orthodontic appliances. In Part-II we will discuss the cons of the changing face of your competition. In Part-III we will discuss the pros and cons of the changing face of your TC procedures.
First there were pinch-fabricated bands and simple brackets that you weld to them, then came preformed bands, some with brackets attached, and finally just cemented brackets—both metal, plastic and ceramic. Then brackets were offered that had specific characteristics to better align teeth – it seemed that brackets were attaining perfection.
At first heavy stainless steel archwires were used. Then came the “Bio-Progressive” technique using lighter forces with lighter, fabricated wires that Dr. Carl Gugino promoted worldwide. This light-wire technique lead to using “Twist-Flex” wire and eventually to heat-activated specialty archwires that applied these lighter forces over months instead of weeks. And of course there were many auxiliary appliances invented that improved treatment results.
A major change came with plastic aligners that at first needed brackets to finish the cases, but eventually worked on their own for those who learned to use them well. But much of this came with a dollar, Tx quality and practice growth/decline price tag. This will be covered in detail in Part-II of this series.
The Pros & Cons of Archwires:
The con of heavy stainless steel archwires was that they slowed tooth movement and required many appointments. The pros of heat-activated archwires are that they provide lighter force, required fewer archwire changes and allow for much more time between appointments, saving much chairtime. The cons are that they are expensive and that they lure orthodontists into thinking that they can go 12 weeks or more between appointments, causing problems with lost Tx time do to undiagnosed problems requiring increased chairtime and many more months of chairtime to correct. It seems that the most realistic timeframe is: 8-10 weeks between appointments for unraveling, 6-8 weeks between appointments for most tooth movements, and 4-5 weeks between appointments for final detailing/finishing the case.
The Pros & Cons of Bands and Brackets:
A pro of switching from bands to brackets was the savings in chair time and the decrease in unattractiveness, especially with clear ceramic or plastic brackets. The con was that it increased the bracket cost many fold. But the pro was the savings in chairtime that recouped the extra bracket cost. Another pro was that these new brackets could be specially created to make treatment faster and more precise.
The newest face of orthodontic brackets:
Recently, a company called “Braces on Demand” allows you to order customized individual plastic brackets that can be 3-D printed and mail to you or a file emailed to you to print on your own in-house 3-D printer. The pros and cons of this new technique are still to be determined as to their structural integrity, adaptability, bonding adherence, etc. This company gives you the ability to design your own individual brackets for each tooth and 3-D print them in your own office (or they can print them for you and mail them to you). Of course, there are companies that allow you to design of your own indirect bracket bonding systems (using specific bracket systems), but you need to be comfortable using bracket trays to bond them to the teeth, something many doctors find too difficult to do. See the management pearl “Is Indirect Bonding for You?” for a better explanation of indirect bracket bonding. Also see the management pearl “Do-It-Yourself Plastic Aligners” indicating the cost of setting up a system for printing your own appliances.
Braces on Demand says that it provides ability to 3D print devices in-office is a novel workflow for the orthodontic field, allowing doctors to customize braces for their patients and print them on-demand, enabling a more convenient and personalized patient experience. The Braces On Demand web application allows orthodontists to use Formlabs’ Denture Teeth Resin to 3D print brackets, molar tubes, and a host of other orthodontic appliances. This specialized material is strong, stable, and available in multiple shades to enable custom tooth tone aesthetics. The web application allows doctors to reduce inventory and provide incredible customization to their patients with over 8 million prescription options. If interested in this service go to: bracesondemand.com
I hope that you will benefit from this discussion. Part-II of this series will deal with how aligners have changed the face of orthodontics.
Getting Enough Love—Revisited
Is sharing love an important apart of your life? Do you share a limited amount of love because you are a strong director, analyzer or socializer—or a weak relator? Do you really share as much love as you want to? Maybe a revisit of a previous pearl may help improve your loving life.
While involved in the many aspects of your practice odyssey over the past few months, you should not have lost sight of an important aspect of a successful practice—that you must love your team and patients; that your team must love you and your patients; and that the patients must love you and your team. This fact has become obvious to me after working with hundreds of practices and thousands of staff over the past 50 years—the more love they shared the more successful their practice is; no matter how big or small. Of course we can’t love everyone all of the time—it has its limits—but we all could do better.
Love is something that most of us are uncomfortable discussing—while craving more of it. Strong relators (or those of us who do not have a weak relator style) can share love more easily than others. No matter what our genetic style strengths are, we all share love—but unfortunately, only when we are using our “bonding” relator style. In general, I find the vast majority (60%) of orthodontists are task-oriented directors and analyzers, about 30% are strong socializers, and about 10% are strong relators—so the majority of us needs help to share more love. Orthodontists with a strong director style and a weak relator style (opposite styles that balance each other out), find it particularly difficult to share love. Orthodontists with a strong analyzer style and a weak relator style also have difficulty sharing love. Socializers feel a lot of joy and interpret it as love, but it isn’t love because there is little bonding involved. But, just because we don’t naturally share love, it doesn’t mean that we can’t or shouldn’t share more.
In the pearl “Are you getting enough love in your life” we discussed the various ways of experiencing love daily. Most of it was to be aware and to “catch a moment of love”, then dwell on it. But there is a more pro-active way of sharing more love daily—you can institute an “attitude” that relators naturally use—being appreciative and thankful.
It seems unrealistic that just being more appreciative and thankful could make such a big difference in our lives, but it does. Most of us take it for granted that when someone does something for us that our “thank you” is implied—it isn’t. We lose something by not saying it and others lose something by not hearing it. By not being appreciative and saying “thank you” we don’t acknowledge to ourselves that, that person did something nice for us and that we are worth it. By not saying, “thank you” we degrade the other person by making their efforts seem meaningless and their life less valuable.
By saying “thank you” we acknowledge to ourselves that we appreciate what this person has done for us, which makes us feel more important. By saying “thank you” the other person feels that what they did is valuable, which makes their life more meaningful. And the sad fact is that a person doing what might be considered “lower status work” actually needs more acknowledgements, but they usually get less.
Over the past year I have experimented with appreciating and thanking others for what they did for me. I did this with clients, anybody I met outside my home, and especially with my family. At first it seemed stilted and disingenuous, but after hundreds of incidences it became natural. I could see the changes on the people’s faces when I acknowledged and thanked them, changing from a “well, that task is done” blank expression to a “my efforts are appreciated” smile. I am a much happier person now that I share more love and appreciation—I whish I had learned this simple fact decades ago.
Thus, whether in your practice, your home or when out and about, if you share an appreciative “thank you”, you will eventually share more love. At first, you will feel a little awkward saying it, but it will eventually become more natural and accepted by others as you naturally emanate positive emotional energy. It is especially effective when you can look someone straight in the eye when saying it and emoting positive energy. Of course, there are those who respond to your “thank you” with “no problem”, which kills the love—but by emanating positive emotional energy you will usually get around that—keeping eye contact also helps. You will also get a “you’re welcome” some of the time, which also feels good. Actually, the more you maintain eye contact emit positive emotional energy, the more positive responses you will receive from others.
And it isn’t necessary to thank everybody for everything—that gets a little stale after a while. For a start, practice maintaining eye contact and saying “thank you” to people outside of your practice when in restaurants, stores, etc., and especially with your family. This will naturally transfer over to your practice. It will take many weeks/months to attain a more loving life, but you will find it well worth the effort and appreciation.
Your Practice Odyssey - Part-7: The Perils of Growing Your PracticeIs your Internal Marketing in place making your current patients love to visit your practice?Is your External Marketing in place, making NEW patient/families want to have their treatment with you?Are there services that you don't currently provide a possible new market for patients?Maybe the 7th part of this series will help you get all of that in prospective.
Your Practice Odyssey - Part-6: The Perils of a New AssociateIs your practice growing out of control?Have you considered a new associate or partner?Do you think that you can handle an associate or partner?Maybe the 6th part of this odyssey series will help you.
Dream Practice Odyssey: Part 6
Your Practice Odyssey - Part-5: The Perils of a New OfficeIs your present office adequate for your needs?Are you considering a new office now or in the future?Have you considered all of the perils of establishing a new office?Maybe the 5th part of this series will help.
Dream Practice Odyssey - Part 5
Your Practice Odyssey - Part-3: The Perils of Marketing (TC) ProgramHave you created a successful marketing program yet?Is your internal marketing (TC) program packing them in?Maybe the 3rd part of this series will help.Dream Practice Odyssey Part 3
Your Practice Odyssey - Part-4: The Perils of Scheduling DesignHave you designed your Ideal Schedule yet? Is it great or just adequate? Maybe the 4th part of this series will help.Dream Practice Odyssey - Part 4
Your Practice Odyssey - Part-2: The Perils of Hiring & TrainingHave you established your Dream Team yet?Have you overcome the many perils of hiring them?Have you overcome the many perils of training them?Maybe this 2nd part of the 7-part series can help.
Your Practice Odyssey - Part-1: The Perils of StaffingHave you established your Dream Practice yet?Have you overcome the many perils to establish it?Maybe this 7-part series will help you establish it.This 7-part management pearl series will be done in videos.Click on the video below to watch it.I hope that this video series helps you to better complete your Dream Practice Odyssey.
Is Hybrid Orthodontics for You?Have you considered doing Teledentistry (virtual dentistry)? Are you aware of how much your patients might appreciate it? Do you think that it would be too difficult to set up in your practice? Well maybe this pearl will help you to decide.Schools are not the only hybrid social entity today, much of the world’s services are now hybrid (both electronic & in-person). Most orthodontic services need to be done in person, but many don’t. All of those “look-see” patient visits can be done virtually saving the patient/family the inconvenience of a trip to the office for the few minutes it takes to tell them what they need to know.The patient/families that can benefit from virtual orthodontics include:
You can schedule virtual appointments just as easy as you can schedule in-person appointments:
When conducting a virtual appointment, make sure the patient has the same app on their cell phone as you do (or have them all on your phone) so that you can call them and observe the state of their dentition, oral health, etc.
Have the receptionist call that patient at the designated date & time and then give the phone to the person responsible for that patient. Or, have the responsible person call that patient/family. Don’t have the doctor call; just give him/her the cell phone when contact is made.
Since the virtual treatment calls are included in the patient’s treatment (as they should be) you won’t have to set up payment mechanisms to pay for the call. This is a big advantage over telemedical calls by physicians.You might find the attached PDF “ADA Policies on Teledentistry” worth reading.I hope that this pearl has helped more than confused you on how Virtual Orthodontics can help make your practice more state-of-the-art and patient-centered. |
