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Office Visit: Smiling in St. Louis Benjamin Lund, Editor, Orthotown Magazine

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Orthotown Magazine is pleased to present an interview with one of the most active and outspoken members of Orthotown.com, Dr. Andy Hayes, aka "ahayes"

by Benjamin Lund, Editor, Orthotown Magazine

Welcome to the third installment of Office Visit, where we visit a Townie's office and profile his or her equipment, office design or unique practice philosophy. If you would like to participate or nominate a colleague, please send me an e-mail at ben@farranmedia.com.

This month, we visited Dr. Andy Hayes, one of the most visible Townies on Orthotown.com (you might know his avatar photo as his son, Drew's face creatively placed on Superman's flying body). In this interview Dr. Hayes explains what got him interested in orthodontics, how he practices, what new technologies and procedures he performs each day and what he has learned through Orthotown.com.
Name: Andy Hayes, DDS, MSD
Townie name: ahayes
Graduate from: Indiana University School of Dentistry
Year graduated: 2004/2006
Practice Name: St. Louis Orthodontic Group (official orthodontist of the St. Louis Rams)
Practice Location: O'Fallon, Missouri
Year when this office opened: 2006
Practice Size: 4,600 square feet / five treatment operatories, three exam/private treatment rooms
Staff: Nine total: Six chairside (including one acting as new patient/records coordinator), two scheduling coordinators and one office manager.
Web site: www.stlouisorthogroup.com

Office Highlights
Bonding Agents
• Reliance Enhance L.C. Adhesion Booster
• Reliance Porcelain Etch and Conditioner
• Reliance S.E.P. — Self Etching Primer

Brackets/Wires
• Forestadent 2D Lingual Bracket — 3rd Generation
• Ormco STb lingual brackets 0.018", high torque Rx
• T.P. InVu ceramic 0.018", MBT Rx
• T.P. Nu-Edge 0.018", MBT Rx

Cements
• GC Fuji ORTHO BAND
• GC Fuji ORTHO LC
• Reliance FlowTain
• Reliance Light Bond

Class II Correction Appliances
• Carriere Distalizer — Class I Orthodontics
• MARA — DynaFlex Laboratory
• Twin Force Bite Corrector — Ortho Organizers

Click Here To View Dr. Hayes' Top 5

Class III Correction Appliances
• CS-2000 DynaFlex Orthodontics
• Fixed Tandem Appliance — DynaFlex Orthodontics
• Protraction Head Gear

Impression Material
• Kromopan Alignate
• Silgimix PVS alignate substitute

Technology
• Dolphin Imaging, Ceph Tracing and Analysis,
  and Treatment Planning Software
• G&H Wire Co. Orbit Mini Screws
• Hoya Diodent Micro diode laser (980nm)
• Ortho II ViewPoint Practice Management Software
• RMO Dual Top mini screws
• Sirona Digital X-Rays
• TeleVox HouseCalls Automated Messaging System
• Zap OrthoLase diode laser (810nm)

Why did you choose orthodontics as your career path?
I'm not sure whether I chose orthodontics or orthodontics chose me. My father is an orthodontist and ever since I can remember, people would ask me, "Are you going to be an orthodontist like your father?" Like many, I wasn't sure what I wanted to do with myself. As a result, I followed the bad advice that every teenager receives before going to college, "Find what you like to do and make it your career." That's horrible advice! It does crazy things to naive teenagers, like turn a future orthodontist into an art major for a few years. I don't know exactly why I chose dentistry initially, but I know the exact moment when I was bitten by orthodontics. As a third-year dental student, I stumbled across the book Garden of Orthodontics by Giuseppe Cozzani in the library. It had the most beautiful pictures of cases and really thought-provoking treatment options. I felt the passion and creativity that dripped from every page inside of this book and I knew that was it for me. I had to be in on that. I bet I've read that book, cover to cover, a dozen times.

Tell me about your practice. What do you do that sets you apart from other orthodontists
in your area?
One thing I try to do is give the patients my time and attention and really cater to their chief complaint and then give them a multitude of options — not just what I think will be the most simple correction. It is not uncommon to find that most adolescent and adult patients will have at least three or four choices in their own treatment appliances with conventional metal, tooth-colored or lingual brackets and some with aligners. I will work with patients to find the best source of Class II/III correction to also meet their personal needs, whether it be less visibility, speed, compliance-free options or all of the above.

Since you began your career as an orthodontist, what are the three biggest changes you've seen in the profession?
It hasn't been that long since I started practicing but I have already seen some noticeable changes.
  1. It would be hard to not mention the advancements in 3D CBCT. Just two or three years ago there were only a few options. This past year seems to have been the year of the CBCT. At the AAO it appeared that the majority of the vendors were riding the "CT wave" in some capacity. It's an awesome innovation and a great asset to those patients who need it. That being said, I still find the practicality of the technology unjustifiable for the mainstream patient at this point.
  2. Adults seeking orthodontic treatment and the more adult oriented office. I am amazed as my numbers of adult patients increase. There are days when I am seeing as many adult new patients as adolescents. I don't know whether to attribute this to orthodontic companies marketing directly to patients, the Internet, less noticeable treatment options, a higher dental IQ from aesthetic seeking patients who realize veneers are not the only option for a better smile, or simply just more recommendations by referring dentists or friends.
  3. For me personally, the biggest change in orthodontics has been low-profile lingual brackets. To be able to have the full control of teeth with wires and brackets at every appointment and still be unnoticeable is very powerful. With the lower profile brackets I'm seeing little to no alteration of speech, minimal complaints of irritation and fewer compromises in the finish by me.
What is the most unique case on which you have worked?
From a "unique" perspective I'd have to say doing Invisalign treatments for the wives of St. Louis Cardinals and St. Louis Rams players. Honestly, I think I have lots of unique cases and many of them can be seen on Orthotown.com or Dentaltown.com in some capacity.
What is your biggest source of new patients?
How do you market to new patients?
New patients come from everywhere (that's always a fun line to read on the questionnaire). Like most orthodontic offices, professional referrals are what keep you steady. Another good portion comes from previous patients' recommendations and, of course, there are loads that come in because they saw the sign and live around the corner. There is no external marketing done. The only potential marketing expense is from the Web site that I created and maintain myself for a whopping cost of about $75 a year.
Tracy and Sommer look over a patient's chart in one of the sport memorabilia filled hallways at St. Louis Orthodontic Group.

In your current practice situation, what is a typical day's schedule? What kinds of cases are you doing routinely?
I am very fortunate in this area as I am part of a group practice yet I still operate as a solo practitioner in most capacities. I get a little thrill from the cases that aren't exactly mainstream. I am fortunate to be able to diagnose a greater number of cases and pick many of the unconventional ones to treat myself. So the days that I am working you'd see a much smaller number of Class I crowded cases than a typical office and a higher number of Class II's and III's, laser procedures, transpositions, stubborn cuspids, brackets on the buccal and lingual surfaces, many appliances and gadgets that I'm trying out for the first time and an overwhelming number of MARA appliances for most people's comfort level.

What types of procedures/surgeries do your office perform?
As an orthodontist we are limited in this area, but I try to do just about anything that the AAO liability policy will allow. I use a diode laser routinely for uncovering teeth, gingivectomies, hyperplasia around mini screws and fixed appliances, apthous and traumatic ulcers, prodromal HSV, and I've removed a few fibromas. I no longer deal with laser frenectomies as I feel the patients are better served with a blade for this. I place mini screws from the first molar forward. Not much more than that.

What is your favorite procedure to perform?
Tough question. Anything dealing with lasers is always fun. That's one of the few things in orthodontics that can give instant gratification to you as a clinician (also, it can often make you look like a hero to moms and patients, not to mention get you out of a few binds when implants or appliances get covered by soft tissue).

What kinds of new technologies has your practice embraced? How have they improved your practice?
The first is treating the patients invisibly, if they desire. With the lower profile lingual brackets, I am now able to offer the lingual option in situations I never thought possible. Also, it's been great for the teenager who is scowling in the chair because mom wants her child to have braces and the child does not. I now find that patients who I would have steered away from treatment previously have become appreciative and very cooperative.

The next area would be in the alternatives to surgery department. I use the Dolphin Imaging System treatment simulations to treatment plan the more complex cases that I consider to be alternatives to orthognathic surgery. After mixed results using mini screws in these types of cases, I am now having a surgeon place mini plates as anchorage instead. I think that this is going to be a shift in the profession in the next decade.

The last area is magnification. It's important when you want quality to maximize the things you do right the first time. I want to see those small millimeter discrepancies in bracket placement, tooth size and shape, and marginal ridge alignment very early before the wires work themselves out and definitely before the brackets are removed. Wearing loupes gets me jokingly branded as "Dr. Dorko" by my staff, but the increase in quality and efficiency is worth all the badgering. Besides, loupes are a great conversation piece! I also use magnification in a retrospective way. I analyze (some) cases with an HD projector and a 100-inch screen. I've been able to learn so much from doing this.
Who are the people on your staff and in what
capacity do they function?
The front office consists of two scheduling personnel who deal with the usual day-to-day challenges of any busy front desk while still wearing their bright and happy faces. The office manager deals with a variety of things that include new patient contracts, insurance, payroll and, most importantly, paying my credit card bills.

I run five full-time operatories and three new patient exam rooms that can also be used for retainer adjustments or private treatment rooms. There are five clinical assistants at all times and an additional assistant that is the new patient and records coordinator. Each of the clinical staff share portions of lab and sterilization duties.
Dr. Andy Hayes with his team at the St. Louis Orthodontic Group
in O'Fallon, MO.

How has Orthotown benefited you and the way you practice?
There is really no other means of professional communication out there that can come close to offering what we have with Orthotown. Even the best study clubs around are limited by the number of members and their own members' experiences and biases. Here we have no exclusion criteria other than a specialty license or residency. Where else are you going to see a Roth guy, a Damon guy and a functional guy all coming together to talk about aligners? These paths would not cross otherwise. The ability to post cases and get opinions about critical treatment scenarios is priceless. In almost every aspect of our lives we are able to get professional support at will in regard to our finances, automobiles, computers and technologies, and home repair but when it comes to our profession we can be isolated. So far, there have been nothing but cordial exchanges even with differences in opinions — something that you won't see on many other message boards.
Orthotown Magazine
September 2025
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