Greetings from Your New Editorial Director by Dr. Daniel Grob, DDS, MS, Editorial Director

Living and practicing in the great state of Minnesota comes with some fun nuances.

Hello. I'm Daniel Grob and I love being an orthodontist! Allow me to introduce myself further. After a successful career with a business partner for 25 years (which in this profession is an accomplishment in and of itself) and then bringing in two young orthodontists, I decided to move with my wife and children to the Valley of the Sun (the Phoenix area) and re-invent myself as a practitioner, educator and editorial director.

I've been very fortunate during my 30 years of practice and I'm thankful to my patients, staff and family. Not everything has worked out as planned, both in business and in some of the treatment plans I've handled for 20,000-some orthodontic patients.

However, I've found that with perseverance and good health, I've been able to continue to do what I love to do and that is treat and educate patients. And now I have the privilege of contributing to a premier publication that enhances the lives and careers of my acquaintances and readers I've never met. It's safe to say that currently there are three generations of practicing orthodontists all with their own perspectives on the profession and all with their personal experience and education shaping their decisions. All of these orthodontists have witnessed changes in diagnosis and treatment, payment systems and marketing to patients and dentists.

The traditional business model of the solo orthodontist has remained and been joined by various alternatives. I'm confident that many will survive and a few will be challenged. I've never seen any new trend in dentistry that either completely changed the profession or completely failed.

Many orthodontists, like myself, were educated during the '70s and '80s and witnessed rapid change as direct bonding replaced the tedious job of pinching bands to gain adhesion to the teeth. Functional appliances were reintroduced to North American orthodontists during that period and many premier educators and practitioners traveled abroad to witness firsthand the magical results that were promised and delivered using new laboratory devices.

The arguments regarding articulated study models came to the surface and separated the gnathological from the functional orthodontists. Passionate arguments occurred in literature as well as at continuing-education meetings. "Growing jaws" was now thought to be possible and removing teeth was "so last year," ushering in the latest and greatest technology.

Clear appliances were available, as were colored rubber bands or elastic ties. Little did we know that the same companies that invented some of the most-clear appliances didn't spend nearly as much time or money figuring out how to get them off (do you remember heated bracket removers?). The space program gave us nickel titanium wires—high priced but worth every dollar in reduced treatment time and patient comfort.

The '80s and '90s saw a preoccupation with TMJ treatment and the subsequent jaw surgery that was either the cause or salvation of many of our patients' headaches and worn-out teeth. Little did we know that within a couple of decades, we would turn full circle thanks to advanced imaging and diagnosis and proclaim that TMJ has nothing to do with orthodontic care and TMJ treatment was now referred out to other specialists!

Litigation was prevalent and the AAO and dental schools worked feverishly to prove to the best of their ability that orthodontics was safe, but not without risk.

The end of the past century and the beginning of the new one saw the introduction of TADS. This was at the same time that dental implants were becoming the de facto standard of care in general dentistry, eliminating once and for all the need for removable partial or complete dentures and fixed bridges that only postponed for a while patients' slow transition into edentulousness.

The self-ligating appliances were becoming mainstream with a cult-like following promoting them as the new standard for rapid treatment and comfort.

Clear aligner therapy was introduced and many thought that what was clearly a disruptive technology surely wouldn't last.

And of course cone beam and digital X-rays are now mainstream and almost all new installations include paperless charting, imaging and so forth.

But guess what? Aside from all these advances, growth and cooperation still influence most of the success we see in our orthodontic patients.

Almost every advance has survived to some degree, but just like government, things progress slowly. New technologies all contribute to the advancement of the profession and the quality of patient care. We are treating more patients now for less of their disposable income then ever before and I believe the trend will continue.

Next month, we'll discuss payment and marketing changes. In the meantime, enjoy your practice, and embrace progress.

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