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The Future of Orthodontics Dr. Larry Emmott

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We have seen the future and the future is digital. The sweeping changes that digital technology will bring to dentistry and orthodontics have just begun. Technology will impact everything from how we get a referral, to bringing a new patient into the office, to diagnosis and treatment. Let's take a wild ride into the future and see how some of these changes might look.

Referral
Today: The general dentist feels the patient should see an orthodontist. A referral form is quickly filled out with a couple of boxes checked and X-rays are copied and attached in a envelope. The patient is told to call the orthodontist for an appointment.

Future: An appointment is made at the orthodontist's office via the Internet and then using a smart interactive referral system the patient's information is transferred by a secure network to the orthodontist. The orthodontist's office downloads the patient name and all personal data such as address and phone numbers. In addition, the orthodontist gets all the diagnostic information including the computerized diagnosis and treatment plan. The orthodontist also gets the updated dental history, a history of the treatment rendered and any notes from the general dentist. The orthodontist could also get the X-rays, photos, insurance and payment information.

Today: The referring dentist scribbles some notes and checks some boxes on a paper form and hopes the patient takes it with them to the first consult.

Future: While online, the referring dentist will be prompted to fill in details using a decision tree. A decision tree is an interactive system that guides the user through various selections with each new decision based on the previous answer. For example the system could ask, "Does the patient show any para-functional habits?" If the answer is yes then a new and different set of questions is launched. "Thumb sucking?" "Tongue thrust?" and so on. If the answer to the first question is no, then the system jumps to a completely different question, like "Mixed or adult dentition?"

Once the referring dentist has made it through the decision tree, he/she will have a blank page on which to type detailed notes about the patient.

Today: The orthodontist sends a written thank-you note and tries to stay in touch with referring doctors with letters and the occasional lunch.

Future: The instant the online referral is submitted; the orthodontist's office will automatically acknowledge receipt, confirm the appointment and contact the patient. The orthodontist will also add the new referral to the referring dentist's account noting that they are a "Gold Elite" client. This will prompt all kinds of special treatment, perks and goodies to fall their way!

At this point the orthodontist's Web site could launch a pop-up window to introduce a new procedure or technique. The dentist could ignore it or follow through the links to learn more about the procedure. This could lead to diagnostic criteria, photos, testimonials and even a chance to sign up for an upcoming CE course.

While logged on, the referring dentist could check the progress of any active cases.

Today: The dentist and the orthodontist play phone tag for a few days. Not sure what the total plan for the patient involves, the orthodontist does what seems to be indicated. The orthodontist then creates a report and mails it to the dentist.

Future: Later that day the dentists and orthodontist hold a real-time Internet conference simultaneously viewing and annotating the diagnostics, chart notes and 3D images. Once the patient has been treated by the orthodontist all the notes and communication including photos, X-rays and 3D images from the orthodontist will be sent back to the referring dentist via the Internet and the patient's chart updated instantly.

First Visit
Today: The patient signs in, fills out a stack of forms on a clipboard, and the staff enters the information.

Future: A patient enters the dental office and immediately the PDA in their pocket or purse connects with the dental office system using a wireless connection. This alerts the dental office the patient is there and also instantly updates all personal information such as address, insurance, or changes in family status.

Today: The patient fills out a medical history on paper. Hopefully they can remember everything.

Future: The patient's health history is accessed from the national database and an artificial intelligence (AI) program analyses the information and sends back a condensed report with specific conditions noted, a series of interview questions to ask the patient and appropriate measures stipulated for orthodontic dental procedures.

Today: A highly trained (and expensive) orthodontist reviews the form, interviews the patient, and based on training and experience decides if there are any significant health issues.

Future: Once in the treatment room, a para-professional auxiliary following the print out interviews the patient and speaks the patient's responses to various questions into the computer. The interviewer is then prompted by the computer to ask additional relevant questions. The AI system uses the national database health information, combines it with the patient's specific answers to the interview questions, compares all the information against a database of patients and concludes whether it is safe to proceed with specific diagnostics and treatment.

Today: The orthodontist, with the help of an assistant, gathers diagnostic information; he/she observes the tissue, palpates, looks for red or white lesions, checks the bite, fills the patient's mouth with goo to make models then sends them to a lab for radiographs, photos, cephs and tracings.

The dentist then makes a diagnosis and treatment plan based on his/her subjective evaluations of how things looked or felt compared to others' training and experience.

Future: All diagnostic information is collected in a few minutes using three digital scanning devices. A cone beam-like device does two rapid radiographic scans of the head one with the teeth occluded, and another as the patient opens wide. Simultaneously it takes a visible light image of the facial features. The second scan uses lasers to get a detailed scan of the teeth.

The final device goes in the mouth and does scans with different types of light. This intraoral scan picks up changes in temperature indicating inflammation; it detects bacterial fluorescence indicating the effectiveness of home care and carious activity. It detects calculus. It evaluates translucence. It detects changes in the epithelium that indicate cancer or other changes.

These three digital scans are combined to create a virtual patient.

This digital information isn't seen by the orthodontist but is examined by software. Once the data is collected, software using artificial intelligence compares all the findings to a large database. The database and the diagnostic software are not in the dental office but stored on secure servers the dentist can access through the Internet. The database has a huge range of both normal and pathological findings. Based on this, the software provides a differential diagnosis, a very accurate probability of diagnostic accuracy and a course of treatment.

The software displays a 3D image of the mouth, the hard and soft tissue, even facial features. The virtual patient images show how the teeth will move throughout treatment including the root movements, bone growth and the change in facial features. The dentist can manipulate the image in space to observe from all sides and even watch the TMJ move through an opening sequence.
Author’s Bio
Dr. Larry Emmott is one of the most entertaining speakers in dentistry and is considered the leading dental high-tech authority in the country. He has more than 30 years of experience as a practicing general dentist in Phoenix, Arizona. He has been a featured speaker at every major U.S. dental meeting. He is a regular contributor to leading national magazines. He consults with both dentists and those in the dental profession. He has been a pioneer in online publishing with his blog www.emmottontechnology.com.
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September 2025
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