Embrace Progress: The Year of Transformation by Dr. Daniel Grob

Preamble
Thank you to all who commented on my April column about the roles and expectations of the American Association of Orthodontists and the American Dental Association. As I expected, there were many voices on both sides of the topic and I’m pleased that my rambling stimulated discussion. My role as editorial director goes beyond reviewing articles for publication; one of my goals is to cultivate interest and drive discussion in a variety of subjects regarding orthodontics, dentistry and even culture.

It was sheer coincidence that the column, which I had penned some time ago, appeared in Orthotown magazine the same month that the AAO hosted its Annual Session. To be clear, my intent was to express concern that the ADA and AAO have grown into sizable organizations. Despite their size, they still need to focus on maintaining their integrity, and that includes the integrity of their specialties. By the way, if there is a common purpose between the AAO and the ADA, it would be to showcase products, clinicians and other organizations that work hand in hand with the peeps in the field.

The Annual Session is a great way for everyone in the industry to share knowledge and experience and to discuss progress. The most recent convention was, from my perspective, a transformational event. I’ve spent some time reflecting on the venue, the exhibits and, of course, the clinical program.

Washington, D.C., was the home of the 2018 session, and what’s not to like about the nation’s capital? (Did I just say?that?) No, seriously—the city, outside of the convention sights and distractions, was a pleasure to visit. D.C. is certainly vibrant and full of things to do and places to eat! I overheard residents mention that in years past, the area was empty on weekends but clearly that’s no longer the case. The Walter E. Washington Convention Center was easy to get around and the rooms were easy to find (although I thought some seats could have used a bit more legroom). All in all, a great site and facility. The exhibit space was filled with innovation and energy.

Predictions
We know that within the past few years, the face of our profession has been changed most notably by disruptors outside the field. For those of you who are still grumbling, that is how change usually happens: Meaningful progress in a profession or industry almost always comes from outsiders who see it through a different set of eyes. That might help explain why the presidents and CEOs of many dental and orthodontic manufacturers move from industry to industry—for exactly that reason, bringing experiences learned in other professions.

Other businesses and industries have had major changes foisted upon them—think of the automobile disrupting the horse and buggy, digital cameras versus film cameras, or one of the most recent, ride-booking apps upending the taxi business. (By the way, both founders of Uber worked in web-based companies before creating the popular ride-booking service.)

Changes are rapidly thrust upon orthodontists, too, but it’s interesting that we have just as rapidly adapted. I’m referring of course to clear aligner treatment appliances, their associated technology and the various business models enhancing them and other digital treatment solutions. As painful as this may have been to orthodontists who’ve practiced the same way for years if not decades, it’s encouraging to see how some doctors and organizations have reacted, from creating scanning centers to forming their own large groups with purchasing and marketing leverage.

The fact of the matter is that for many young practitioners, today’s environment is the only environment they’ve known for the past several years—and they’re thriving in it.

What I see from afar is that business- and tech-savvy orthodontists are working with the system to make access to care more affordable and more available—which, in the end, benefits everyone.

New models are being developed, such as virtual treatment or monitoring, in-house manufacturing and even new methods to harness social media to reach patients.

The clinical landscape is rapidly changing, too. There were many new innovative bracket systems at the AAO session worth mentioning, as well as digital imaging and self-ligating appliance systems. Precision bracket placement, the hallmark of straight-wire prescriptions, need not be a concern for those who are willing to use the technology to make it happen.

Keeping track of patients in and out of treatment is one of the most important factors in orthodontic care, and many solutions are now available to make this happen in an automated fashion.

Presentations
The clinical programs at the annual session had something for everyone, but of course it was impossible to hear it all. (That’s one reason that I have subscribed to the audio program for years—so that I can listen later to the lectures I was unable to attend in person.) A clever note in the program indicated which speakers were suggested for new grads and residents, which was extremely helpful for those looking to get the most out of their time spent in the lectures. (Nice job to all on the program committee!)

I was especially impressed that my first lecture was by none other than Dr.?James McNamara, a legendary researcher, educator and clinician who spoke on his experience with early treatment and transverse discrepancies. Anyone who’s still on the fence regarding the efficacy and need for Phase I treatment needs to hear his presentation. I started my professional career with McNamara in the early 1980s, studying the Frankel appliance, and it looks like I might finish my career by incorporating his approach of embracing expansion in younger patients.

TADs seem to have their ups and down in the field; honestly, I have only limited experience with them. However, the trend toward palatal TADs for expansion and intrusion seems to call out for gaining experience with this treatment. From what I’ve understood, the predictability, usage and ease of placement of TADs is becoming more patient- and operator-friendly, so those still on the fence (like me) need to hop on board and take advantage of this game-changing addition. Presentations by Drs. Young-Cheol Park and Jae Hyun Park were well done and explained risks and limitations well.

A treatment option that seems to have fallen a bit out of favor—but still finds some applications—is serial extraction. Those who would like a simple way to categorize their patients into this method of care would have been served well by Dr. David Kennedy’s presentation.

I returned from this year’s Annual Session more energized than ever, and I hope you share the excitement of the profession going forward. Everything I experienced—from the offerings in the exhibit hall to the abundance and variety of lecture topics—tells me that orthodontics is on the verge, or perhaps already in the process, of something quite transformative.