Ortho Tribune U.S.

PCSO goes tropical (Continues on p. 5); Interview Dr. S. Jay Bowman (Continues on p. 6) / Ethics in ortho / News / Out and about in Oahu / Interview with Dr. S. Jay Bowman / Creating a strong foundation / The evolution of IPR / Industry

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ON
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ORTHO TRIBUNE

SP
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The World’s Orthodontic Newspaper · U.S. Edition

September 2010 Supplement

www.ortho-tribune.com

Forget that stud

Ride the waves

Making headway

Tongue piercings may
lead to gaps in teeth

Surfing and other fun
things to do in Hawaii

Our 2010 makeover
winners show progress

uPage

PCSO goes tropical
Annual session
offers continuing
education, social
activities and more
By Kristine Colker, Managing Editor

oing to Hawaii is normally considered a treat. But going to
Hawaii and having access to a
myriad of continuing education sessions, a slew of companies showing
off their newest wares and an array
of social and networking events is
even better.
This year, the Pacific Coast Society of Orthodontists is taking its
74th annual session to the shores of

A view of Waikiki Beach
from Kapiolani Park.
(Hawaii Tourism Japan)

‘I’m fortunate to have found
a career that I’ve embraced’
Dr. S. Jay Bowman talks about how he got
started (blame his father), where he’s been in
his career and why he feels so lucky
By Dennis J. Tartakow, DMD, MEd, PhD, Editor in Chief

Please introduce yourself to our readers and tell us about your background in orthodontics.
I grew up in a very small town
(Abingdon) in the middle of the
cornfields in the western half of
Illinois, attended Illinois Wesleyan
University and then Southern Illinois University, School of Dental
Medicine. I was accepted by Lysle
Johnston into the orthodontic residency at Saint Louis University in
1983 and bought the first of three
orthodontic practices in Kalamazoo,
Mich., in 1985.
Primarily, I am a clinician, but, I
am honored to have been asked to
teach at three universities: adjunct
associate professor at Saint Louis
University, clinical associate professor at Case Western Reserve
University and an instructor at
the University of Michigan, where
I developed a straightwire course
that I’ve taught for 10 years.
g OT page 6

Oahu and the Hilton Hawaiian Village Beach Resort & Spa. The festivities are set to begin Saturday, Oct. 9,
and last until Tuesday, Oct. 12.
According to organizers, some
changes have been implemented to
attract more PCSO members and
their staffs. For instance, the doctor
program will begin with a president’s lecture from Past AAO and
PCSO President Dr. Don Joondeph
and will continue with a lineup of
U.S. and international speakers,
most of whom are new to PCSO
meetings.
In addition, the staff program
has been changed to introduce new
speakers to PCSO and to provide
more useful information for experienced staff.
g OT page 5

Win a free
makeover for
your practice!

Are you ready to update
the systems in your
practice in order to grow?
If practice growth is a
major goal of yours and
you are willing to make
the necessary changes to
achieve that goal, apply to
win the 2011 annual Levin
Group Total Ortho Success
Practice Makeover.
uPage

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[2] =>

From the Editor

Ortho Tribune | September Supplement

Ethics in ortho
By Dennis J. Tartakow, DMD, MEd, PhD,
Editor in Chief

ccording to Thomas Moore
(1779–1852), “One of the greatest problems of our time is that
many are schooled but few are educated” (Howe, 2003, p. 268).
Although we do not recite any
type of Hippocratic oath — an oath
that is required of all newly graduated physicians in the United States
— asking future dentists to allege
not to do harm is rather ludicrous.

“Do no harm” is assumed and is an
ethic that is expected.
In general, there are at least two
ways to do harm: sins of commission and sins of omission. A dentist
can harm a patient with the knowledge that he knows and with what
he does not know.
The words excellence, ethics,
professionalism and leadership are
just a few of the terms emphasized
by the American College of Dentists
in its mission statement that applies
to every dentist.
This mission statement is a great
start for each of us to consider,
reflecting the purpose of the services that we provide to our patients
and staff; it should guide our actions,
spell out our goals, provide a sense
of direction and guide our ultimate
decision-making.
It should provide the framework
or context within which our objectives are formulated, proposed and
performed.
A fundamental and basic aim of
orthodontic education is to explain
and demonstrate comprehensive
approaches to communicating,
diagnosing and treatment planning.

An interdisciplinary approach to
learning involves psychology, sociology and other behavioral sciences, all of which must be considered
in order to provide our students
with an enhanced and enigmatic
knowledge base.
This requires the cognizance of
pragmatic realities for time/motion
constraints, insurance limitations
and all other office issues that are
central to treating our patients.
Orthodontic
educators
and
administrators must also have a fundamental understanding of human
behavior and motivation and present these human rights issues and
relationships to our residents.
This will help the students develop greater understanding of the cultural differences and boundaries of
our diverse patient population.
A chain is as strong as its weakest
link, and in order to provide optimal
health care for our patients, the
orthodontist and staff must strive
to work in concert with each other.
However, the heart of our concerns
should be focused on compassion,
understanding and empathy for the
patient’s comfort, health and best
interest.
Only through thoughtful supervision, planning, congruity and focus
can these needs and objectives of
the orthodontist be achieved at the
highest level. OT

Reference
• Moore, T. (2003). In R. Howe
(Ed.), The quotable teacher (p.
268). The Lyons Press: Guilford
Connecticut.

Corrections

Ortho Tribune strives to maintain
the utmost accuracy in its news and
clinical reports. If you find a factual error or content that requires
clarification, please report the details
to Managing Editor Kristine Colker at
k.colker@dental-tribune.com.

Image courtesy of Dr. Earl Broker.

ORTHO TRIBUNE
The World’s Orthodontic Newspaper · U.S. Edition

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r.goodman@dental-tribune.com
Editor in Chief Ortho Tribune
Prof. Dennis Tartakow
d.tartakow@dental-tribune.com
International Editor Ortho Tribune
Dr. Reiner Oemus
r.oemus@dental-tribune.com
Managing Editor/Designer
Ortho Tribune & Show Dailies
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Published by Dental Tribune America
© 2010, Dental Tribune International
All rights reserved.
Dental Tribune makes every effort to report
clinical information and manufacturer’s
product news accurately, but cannot assume
responsibility for the validity of product claims,
or for typographical errors. The publishers
also do not assume responsibility for product names or claims, or statements made by
advertisers. Opinions expressed by authors are
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OT Editorial Advisory Board
Jay Bowman, DMD, MSD
(Journalism & Education)
Robert Boyd, DDS, MEd
(Periodontics & Education)
Earl Broker, DDS
(T.M.D. & Orofacial Pain)
Tarek El-Baily, BDS, MS, MS, PhD
(Research, Bioengineering & Education)
Donald Giddon, DMD, PhD
(Psychology & Education)
Donald Machen, DMD, MSD, MD, JD, MBA
(Medicine, Law & Business)
James Mah, DDS, MSc, MRCD, DMSc
(Craniofacial Imaging & Education)
Richard Masella, DMD (Education)
Malcolm Meister, DDS, MSM, JD
(Law & Education)
Harold Middleberg, DDS
(Practice Management)
Elliott Moskowitz, DDS, MSd
(Journalism & Education)
James Mulick, DDS, MSD
(Craniofacial Research & Education)
Ravindra Nanda, BDS, MDS, PhD
(Biomechanics & Education)
Edward O’Neil, MD (Internal Medicine)
Donald Picard, DDS, MS (Accounting)
Howard Sacks, DMD (Orthodontics)
Glenn Sameshima, DDS, PhD
(Research & Education)
Daniel Sarya, DDS, MPH (Public Health)
Keith Sherwood, DDS (Oral Surgery)
James Souers, DDS (Orthodontics)
Gregg Tartakow, DMD (Orthodontics)
& Ortho Tribune Associate Editor

[3] =>

News

Ortho Tribune | September Supplement

Apply for the 2011 Levin Group Total
Ortho Success Practice Makeover

Keep your tongue free from piercings and your teeth free from gaps.
(Photo/Serghei Starus, Dreamstime)

Tongue
piercings
linked to
teeth gap

laying with a pierced tongue
stud could lead to a gap between
front teeth, according to a new
study. The research, which was carried out at the University at Buffalo in New York, suggested tongue
piercings could be a major cause of
unnecessary orthodontic issues.
The report claimed those with
tongue piercings were likely to push
the metal stud up against their teeth
and consequently cause gaps and
other problems to arise.
Dr. Nigel Carter, chief executive
of the British Dental Health Foundation, said the study highlighted
the risks that tongue piercings have
on oral health. “As well as causing
an apparent gap, oral piercings can
also lead to chipped teeth and infection,” Carter said.
Lead author of the study, Sawsan
Tabbaa, said that “force, over time,
moves teeth” and that the effects
of people playing with their studs
crop up in a “very high percent of
the cases.”
A professor of orthodontics at the
University at Buffalo School of Dental Medicine, Tabbaa explained that
tooth damage was common in both
past and current case studies.
The study featured a 26-yearold female patient and showed that
a space between the upper front
teeth had appeared during a period
of seven years, during which the
metal bar was pushed against and
between the teeth.
The patient provided researchers with photographs to show she
had no diastema before having
her tongue pierced. It was strongly
thought that positioning the tongue
stud between the maxillary central
incisors caused the midline space
between the front teeth.
The results of the study were
published in the Journal of Clinical
Orthodontics. OT
(Source: British Dental Health
Foundation)

Are you ready to update the systems in your practice in order to
grow? If growth is a major goal of
yours and you are willing to make
the necessary changes to achieve
that goal, apply to win the 2011
annual Levin Group Total Ortho
Success™ Practice Makeover.
Levin Group is once again
embarking on a quest to find an
orthodontic practice that is excited
to reap the rewards of a free yearlong orthodontic practice management and marketing consulting
program.
When was the last time you

took a close look at your practice’s
systems? Whether you are in the
beginning stage of your career or
already experienced and successful, growth is always within your
reach — even in this economy.
The winning orthodontist will
experience improvements in every

aspect of running his or her practice. This free, one-year management and marketing makeover will
be a customized approach based on
the orthodontic practice’s unique
needs, goals and potential.
The winning practice’s journey
will be featured in Ortho Tribune
and on www.ortho-tribune.com.
To apply, go to www.levingroup
ortho.com. The deadline is Nov.
30. For more information, contact
Lori Gerstley, senior professional
relations manager at Levin Group,
at (443) 471-3164 or lgerstley@
levingroup.com.

[4] =>

4

PCSO Preview

Ortho Tribune | September Supplement

Out and about in Oahu
W

elcome to Hawaii! Now that
most of us have flown here,
from across the country or
even from across the world, you
don’t want to miss this opportunity
to see the best of what Hawaii and
Oahu have to offer.
With Waikiki as a central hub,
you can explore the legendary
North Shore one day and spend the
next on the east side snorkeling at
Hanauma Bay, a protected marine
sanctuary with tons of colorful fish.
Thrill seekers can skydive at Mokuleia while daydreamers can relax
peacefully on the beach.
Here is a closer look at some

activities you’ll want to be sure you
check out.

The North Shore
If there is such a thing as a perfect wave, you’ll likely find it on
the North Shore. The big, glassy
winter waves of this legendary surf
mecca attract the best surfers in
the world. Stretching for more than
seven miles, the beaches of the
North Shore host the world’s premier surfing competitions including
the Super Bowl of wave-riding, the
Vans Triple Crown of Surfing.
To get to the North Shore, drive
along northwestern Kamehameha

A surfer takes on Oahu’s North Shore. (Hawaii Tourism Authority/Kirk Lee
Aeder)

AD

Highway (Highway 83) from Haleiwa to Sunset Beach. From Waikiki,
it takes about 45 minutes to get to
Haleiwa and an hour to get to the
beaches. Some places to visit:
• Waimea Bay: Waimea Bay is the
birthplace of big wave surfing and
is the venue for the Quicksilver in
Memory of Eddie Aikau Big Wave
Memorial. This surf competition
pays homage to legendary surfer
Eddie Aikau and only takes place
when the epic Waimea waves are
at least 20 feet high.
• Banzai Pipeline (Ehukai Beach):
The merciless waves of Pipeline
break just 50 to 100 yards off the
beach over a shallow reef, making this one of the most dangerous surf spots in the world.
• Sunset Beach: The northernmost
surf spot on the North Shore is
Sunset Beach. The long wavebreaks here are the setting for the
O’Neill World Cup of Surfing, the
second contest in the Vans Triple
Crown of surfing.
• Haleiwa: This laid-back surf town
with a country feel is the gateway
to the North Shore, filled with
great restaurants and shops.

Waikiki
World-famous Waikiki was once a
playground for Hawaiian royalty.
Known in Hawaiian as “spouting
waters,” Waikiki was introduced to
the world when its first hotel, the
Moana Surfrider, was built on its
shores in 1901.
Today, Waikiki is a gathering
place for visitors from around the
world. Along the main strip of Kalakaua Avenue you’ll find shopping,
dining and entertainment.
At Waikiki Beach, a statue of
Hawaiian hero Duke Kahanamoku
welcomes you with open arms.
Regarded as the “Father of Modern
Surfing,” Duke grew up and surfed
in Waikiki during the turn of the
century. Discovered as a swimming
sensation, he won Olympic gold
medals in the 100-meter freestyle
in 1912 and 1920, then went on to
act in Hollywood and use his fame
to spread the popularity of surfing.
Waikiki has a variety of beaches.
The main stretches include:

[5] =>

PCSO Preview

Ortho Tribune | September Supplement

An aerial view of Hanauma Bay.
(Hawaii Tourism Authority/Heather
Titus)
• Waikiki Beach: This is the classic shoreline behind the Sheraton
Waikiki, the Royal Hawaiian Hotel
and the Moana Surfrider.
• Kuhio Beach: When the world
thinks of Waikiki, this golden
stretch of sand along Kalakaua
Avenue is what comes to mind. To
the east, Kapahulu Pier extends
into the Pacific, giving you a view
of the Waikiki shoreline. The rock
“Wall” shelters the beach, providing a tranquil spot to swim.
• Queens Surf Beach: Past the volleyball nets at the Diamond Head end
of Waikiki, the beaches get less
crowded and grassy areas spring
up, offering spots for picnicking.
To learn more about Waikiki’s
history, take a stroll along the Waikiki Historic Trail, which highlights
23 historic sites, 19 of which are
marked by bronze surfboards with a
wealth of historical information.
The trail begins at the Royal
Hawaiian Center in the heart of
Waikiki. The Royal Grove in historic Helumoa was once home to
10,000 coconut trees. The trail continues to the sacred Wizard stones
off of Kuhio Beach; King’s Village, a
shopping center that was once the
residence of King Kalakaua; and the
Duke Kahanamoku statue.

Pearl Harbor
Pearl Harbor, named for the pearl
oysters once harvested there, is the
largest natural harbor in Hawaii and
the only naval base in the United
States to be designated a National
Historical Landmark. The aerial
attack on Pearl Harbor resulted in
2,390 dead and hundreds wounded,
and drove the United States into
World War II. Today, these attacks
are honored by memorial sites.
• USS Arizona Memorial: At 8:06
a.m. on Dec. 7, 1941, the USS
Arizona was hit by a 1,760-pound
armor-piercing bomb, which
ignited its forward ammunition
magazine. The catastrophic explosion that resulted sank this massive battleship in nine minutes,
killing 1,177 crewmen. Begin your
tour at the Visitor Center where
you can view a film about the
attack and view plaques honoring
lives lost on that fateful day. You’ll
then take a boat shuttle to the
USS Arizona Memorial, a floating
memorial built over the sunken
hull of the Battleship USS Arizona,
the final resting place for many
of the ship’s crew. In the shrine
room, a marble wall exhibits the
names of the men who lost their
lives on the Arizona.

• Battleship Missouri Memorial:
General MacArthur accepted the
unconditional Japanese surrender
that ended WWII on Sept. 2, 1945,
on the Surrender Deck of the Battleship Missouri Memorial. Today
the massive “Mighty Mo” is a living museum, with exhibits spanning three wars and five decades
of service. Explore the decks of
this 60,000-ton battleship, three
football fields long and 20 stories
tall. Stand on the Surrender Deck
and view the documents that
ended the war. Take a tour and
get special access to restricted
areas. And don’t miss the ship’s
most stunning feature: towering
16-inch guns that could fire a
2,700-pound shell 23 miles. OT
(Source: Hawaii Visitors
and Convention Bureau)

f OT page 1

Topics for doctors include
advances in cleft and craniofacial
surgery, evidence-based approaches and, geared for those new to
practice, becoming a 3-D practitioner. For staff, topics include such
things as harnessing the power of
the Internet, financial considerations and case acceptance.
Throughout the weekend, there
will be numerous events, such as:
• Welcome reception, Oct. 9: This
kick-off event takes place on the
Grand Lawn of the Hilton Hawaiian Village. Grab a cocktail and a
bite to eat while listening to music
and participating in activities.
• Component breakfasts for California, Nevada, Oregon and Washington, Oct. 10: Network with colleagues and catch up with what’s

happening in your component
society.
• President’s lecture, Oct. 10:
Joondeph will speak on “Traverse
the Transverse.”
• PCSO awards and opening luncheon, Oct. 10: Dennis Snow, an
alumni of Walt Disney, will speak
on “Lessons From the Mouse
— A Guide for Applying Disney
World’s Secrets to Your Organization, Your Career and Your Life.”
• AAOF reception, Oct. 11: Sponsored by Ultradent, this event celebrates the foundation programs
that support continuing research
in the orthodontic profession.
• Alumni receptions, Oct. 11: Receptions will be held for those from
the University of Alberta, UCLA,
UCSF, University of the Pacific,
Loma Linda University and the
University of Washington. OT
AD

[6] =>

Interview

Ortho Tribune | September Supplement

f OT page 1

What motivated you to become an
orthodontist?
I grew up thinking I would either be
a family physician, like my father,
or a rock musician. When I was
a senior in high school, my dad
pulled me aside and suggested that
I consider orthodontics. He had a
lot of foresight, predicting managed
care and potential socialization of
medicine.
It was not until I was in my third
year of dental school that my attention did turn to orthodontics. Years
later, I was having dinner with Buzz
Behrents, chairman of Saint Louis
University, and it suddenly struck
me that it was because of Buzz that
I had the seed of an orthodontic
career planted in my head.
Buzz’s father and my dad were
physicians at the same hospital in
Galesburg, Ill. Although, Buzz and
I had never previously met, our
two fathers must have been talking
about their sons’ future plans. Behrents told my dad that his son was
entering into an orthodontic career;
later I was advised to do the same.
As if by design (or just plain coincidence), we were both accepted by
the same chairman, Lysle Johnston:
Buzz at Case Western and me at Saint
Louis University, 10 years apart.
When and how did you open your
orthodontic practice?
During my orthodontic residency,
my wife and I were looking for
a place to settle “somewhere in
the Midwest.” We’re both from the
same rural area, and although we
enjoyed our time in St. Louis, we
were anxious to return to a smaller community. Consequently, we
looked at a variety of practices that
were for sale in many different
states. We finally settled on a small
practice in Kalamazoo, Mich.
Lysle Johnston’s influence was
felt again as he is the one who suggested the community would be an
excellent fit for us, and he was, as
usual, correct.
What special areas of education,
research or clinical activities are you
most interested in and why?
I had never originally intended on
ever standing up in front of an audience to speak, or to invent anything,
or to write any papers. It seems
that all of this happened by accident to some degree. My wife and I
never imagined that we would have
the unique opportunities to travel
the world or that anyone would be
interested in anything I would have
to say about orthodontics.
My first lectures involved the
controversial issues of extraction/
nonextraction treatment and a critique of Phase I treatments. I also
had been combining methods of
molar distalization with fixed functionals from a very early stage in my
practice to deal with patient compliance issues.
I decided I would document
these methods, especially because
many of the dentists in my area
were not familiar with the devices

Dr. Jay Bowman with Buzz Behrents and Lysle Johnston at the AAO in Washington, D.C. (Photos/Provided by Dr.
Jay Bowman)
Dr. Jay Bowman
works on lecture
presentations with
Ramesh Sabhlok
of Dubai.

Dr. Jay Bowman rocks the keyboards at his 35th class reunion
with his old band, Shiver.
I was using. Consequently, the first
papers I wrote were descriptions
of these mechanisms and reviews
of controversial and contentious
issues in our specialty.
I’ve been involved in research
examining the effects of molar
distalization and reducing enamel
demineralization, and I am one of
four doctors on the Invisalign Teen
Research Team.
About 1996, I was asked by the
president of American Orthodontics to develop a low-profile v-slot
bracket system with associated
auxiliaries (the Butterfly System),
and that lead to creation of numerous devices, including the Monkey
Hook and Kilroy Springs for impacted canines; the TAD Bite Opener,
Ulysses Spring and Propeller Arm
for mini-screw applications; the patented Bowman Modification Distal
Jet and Horseshoe Jet (supported by
mini-screws); Aligner Chewies and
Retainer Retrievers for Invisalign,
and several other simple solutions
to everyday clinical problems.
How did you get involved in teaching
at orthodontic residencies?
More than 10 years ago, I received a
call from Lysle Johnston at the Uni-

versity of Michigan. He said, “Doc,
I’d like you to create a straightwire
typodont course for the troops.”
After I pulled my jaw off the floor,
I did what most folks do when Lysle
asks for something: I simple said
“Yes — but how much time do I
have?”
He told me “a couple months,” so
I dropped everything and created
a manual and typodonts, and I’ve
been giving this course for first-year
residents ever since.
Lysle always impressed upon us
as students to “give a little something back to the specialty.” It could
be donations of money, time and
expertise in the form of teaching,
writing, inventing or being part
of organized orthodontics. It just
turned out I have done a little of
each of them.
In your opinion, is there a need to
change the way higher educational
programs in this country educate
their orthodontic residents?
I don’t think the majority of orthodontic programs are specifically
a concern, although we are experiencing the accelerated loss of
some our most influential leaders
in recent years. More importantly,

practitioners do have a choice to
make. We read that there is an
emphasis on evidence-based care;
however, in the same breath, we
flippantly ignore the evidence as
seemingly unimportant when it
doesn’t square with what we have
often chosen to provide as “treatments” for patients. There appears
to be more concern for the appliance than the science.
So, unless orthodontists choose to
value the “products” generated by
academia (namely, research), over
the unsubstantiated claims of those
selling something (often, whose
only duty is to their shareholders),
then the specialty will likely devolve
into simply a “trade,” as the impetus
to teach/research is lost.
To paraphrase my mentor, Lysle
Johnston, “Scientific evidence
is not just a theoretical nicety, it
is a necessity,” the life-blood of a
learned calling.
As an educator and clinician, what
orthodontic techniques do you teach?
At the University of Michigan, I
was fortunate to have been asked
to teach a straightwire typodont
g OT page 8

[7] =>

[8] =>

Interview

Ortho Tribune | September Supplement
able to reunite our rock band from
high school to play two shows for
our class reunion, 35 years after
our last performance — at the very
same venue. We worked for about
three years to pull this off, and
it was very satisfying to be able
to perform the same three sets of
music again with the same guys
from back-in-the-day. As rock musician Pete Townsend said, “I may be
old, but I ain’t borin’!”

f OT page 6

course that includes the application
of vertical slot auxiliaries, molar
distalization and fixed functionals. I
intend for students to expand their
“tackle box” armamentarium and
consider a “loose-leaf” reference
manual, rather than a cookbook
philosophy.
Specifically, I’d like them to
consider at least three options for
most any clinical situation. I hope
to instill an interest in exploring
all aspects of our specialty with an
open but critical and skeptical mind
— perhaps less cynical than mine.
What hobbies do you enjoy?
I’m fortunate that my avocation is
also my vocation. I have enjoyed
teaching, creating lectures, sharing experiences and travels around
AD

Dr. Jay Bowman and his wife of 31
years, Sherry, visit Snoqualmie Falls
in Washington.
the world with family while making
new friends and all-the-while thinking about problems and creating
simple inventions to help to solve
them.
On another note, I was recently

Looking back at your career, would
you do anything differently?
I suppose I might have made things
easier by simply following the path
of least resistance: flavor-of-themonth orthodontic fads and popular
gurus during the past 25 years. But
I didn’t jump on routine functional
appliances, early aggressive treatments, slippery braces, the avoid-

ance of extraction-at-all-costs, the
selling out of my practice to some
management group or the adoption
of hard-sell marketing.
I decided to become immersed
in research-based concepts and
focus on looking for innovative
solutions. As a result, I was able to
design my own orthodontic offices,
develop my own line of braces and
create a system of devices to compliment treatment that I feel comfortable and proud to provide for
the people who seek our advice and
assistance.
In the process, I grew an orthodontic practice by creating relationships built on trust. So, I guess
there aren’t too many things I would
have done differently.
Do you have any final comments for
our readers?
Orthodontics is a life-long learning
process, and there always appears
to be more and more to learn. It’s
sometimes overwhelming to consider.
As Alexander Pope wrote: “A little learnin’ is a dangerous thing,
Drink deep or taste not the Pierian
Spring.”
Or to paraphrase the mathematician Alfred North Whitehead: “How
much orthodontics do you need to
know? Enough not to be taken in
by it.”
I’m fortunate to have found a
career that I’ve embraced — pun
intended — completely, and I
enjoy being involved in so many
aspects. OT

OT About the author
Dr. Bowman
is a diplomate
of the American Board of
Orthodontics,
a member of
the Edward H.
Angle Society
of Orthodontists, a fellow of
the American
College of Dentists, fellow of the
Pierre Fauchard Academy International Honor Organization, a charter
member of the World Federation of
Orthodontists and is a regent of the
American Association of Orthodontists Foundation. He developed and
teaches the Straightwire course at
the University of Michigan, is an
adjunct associate professor at Saint
Louis University and is a clinical
assistant professor at Case Western
Reserve University. He received the
Angle Research Award in 2000 and
the Alumni Merit Award from Saint
Louis University in 2005.

OT Contact
Dr. S. Jay Bowman
Kalamazoo Orthodontics, P.C.
1314 West Milham Ave.
Portage, Mich. 49024
Phone: (269) 344-2466
E-mail: drjwyred@aol.com
www.kalamazooorthodontics.com

[9] =>

[10] =>

Practice Matters

Ortho Tribune | September Supplement

Creating a strong foundation
By Jennifer Van Gramins and Cheri Bleyer

(This is the third in the Levin
Group Total Ortho Success™ Practice
Makeover series.)

ummer is a busy time for ortho
practices as more parents opt to
start treatment for their children
while school is out. In addition, it’s
prime vacation time, which means
practices are often short-handed as
staff members take time off.
In spite of those challenges, Dr.
Michelle Gonzalez and her team
have been making headway on
their practice makeover by documenting and updating systems and
implementing consistent marketing
strategies.
“I am happy with what we have
learned about the practice and the
progress we have made so far — but
I also realize how much there is for
us to do to reach our full potential,”
Gonzales said.
With our guidance, Gonzalez
put the finishing touches on the
practice’s mission and vision statements. These two documents are
crucial steps for guiding the practice to achieve its potential. The
mission details where the practice
is today, and the vision lays out
where the practice is going for the
next three to five years.

Building a buzz

The practice kicked off the summer with an open house celebrating Gonzalez’ 15 years as a practice
owner in San Rafael, Calif. More
than 60 referring doctors and staff
attended the catered event.
“It was the first time we hosted
such an event, and it turned out even
better than we expected,” Gonzalez
said. “We knew it was a great success when people did not want to
leave; they were having too much
fun.”
Referral marketing is about building relationships, which requires
consistent contact with doctors and
their teams throughout the year.
Hosting an annual or semiannual
event is a great way to socialize with
colleagues and their teams.
In addition to the open house, the
practice has ramped up its referral marketing efforts throughout
the summer. Practice Coordinator
(or what Levin Group calls a Professional Relations Coordinator)

LeAnn has been visiting all referring offices, including infrequent
referral sources.
Some orthodontists believe it’s
a waste of resources to spend time
marketing to dentists who hardly
ever refer. But often when you pay
attention to these offices, they will
think of your office when it comes
time to refer their patients.
By marketing to all referral
sources in her geographic area,
Gonzalez received a referral from
a dentist who had stopped referring
years ago. This success will continue, as long as the referral marketing
program is consistently maintained.

Retooling the schedule
Gonzalez and her team have finished the process of procedural time
studies, which is key to constructing
an accurate schedule. The schedule
serves as the cornerstone for all
systemic change in the practice. An
inaccurate schedule leads to lost
productivity, appointment overruns
and increased stress for the team.
“We are trying to create an ideal
(optimal) schedule that reflects our
current strengths and services,”
Gonzalez said.
The practice has installed computers at each operatory chair,
making it easy for the clinical team
to schedule patients for adjustments
and follow-up appointments.

Benchmarking performance
The practice is now using what
Levin Group calls Key Practice
Expanders™ — 15 critical indicators
that measure practice performance,
including:
• Production
• Starts
• Collections
• Case acceptance ratio
• Overhead
• Overdue accounts
• No-shows and last-minute cancellations
• Observations
• New patients
• Total referrals
• Number of referral sources

• Referrals per doctor
• Total number of patients referred
• Number of starts per referral
source
• Trends in referral patterns
Among the areas the practice is
targeting for improvement is case
acceptance. Currently, the office
sees new patients for an initial
exam and records and still has a
separate consult to review records.
Gonzalez and her team are working
to streamline this process while still
providing optimal service.
The new patient experience plays
a critical role in the case acceptance process. In today’s economy,
more and more parents are shopping around for the “best deals” on
orthodontic treatment. By exceeding patient and parent expectations
right from the start through superior
customer service, orthodontists and
their team can make their practice
the No. 1 choice for new patients.

Conclusion
Gonzalez and her team will be heading to the Levin Advanced Learning
Institute in Phoenix for Phase II of
their consulting experience. During this two-day session, the team
will receive advanced training on
case presentation, collections and
customer service, setting the course
for the second half of the practice’s
makeover.
To jumpstart your own Total Success Ortho Practice Makeover, come
experience Dr. Roger P. Levin’s next
Total Ortho Success Seminar being
held Dec. 2–3 in Las Vegas. Ortho
Tribune readers are entitled to receive
a 20 percent courtesy. To receive this
courtesy, call (888) 973-0000 and
mention “Ortho Tribune” or e-mail
customerservice@levingroup.com
with “Ortho Tribune Courtesy” in the
subject line.
Orthodontists interested in getting
their own Levin Group Total Ortho
Success Practice Makeover can now
apply online to win one by going to
www.levingrouportho.com. OT

OT About the authors
Cheri Bleyer, Levin Group senior
consultant
Bleyer joined Levin Group in
2003 as a Levin Group orthodontic management and marketing
consultant. As a senior consultant,
Bleyer has played a key role in
the development of Levin Group’s
ever-expanding marketing program, and she regularly lectures
at the Levin Advanced Learning
Institute.

Cheri Bleyer, left, and Jen Van Gramins

Jen Van Gramins, Levin Group
consultant
Van Gramins has spent the last four
years working as a Levin Group orthodontic management consultant. Prior
to that, she managed medical and dental practices for 12 years. She served as
practice manager for the Oral Health

Clinic at Loyola University Medical
Center in Maywood, Ill.
Visit Levin Group on the Web at www.
levingrouportho.com. Levin Group also
can be reached at (888) 973-0000 and
customerservice@levingroup.com.

[11] =>

Industry 11

Ortho Tribune | September Supplement

The evolution of IPR
By Paul A. Rocke, DDS, MS

olton focused orthodontists’
attention on the need to alter
the mesial-distal dimensions of
teeth for optimal occlusion. Peck
and Peck1 offered another rationale
for interproximal enamel reduction
(IPR) during a time when orthodontists were still banding teeth.
Their protocol relied upon the
need to reduce the mesio-distal
dimensions of the mandibular incisors to coincide with their facial-lingual dimensions. Clinicians needed
to make such reductions before
banding the teeth, and those reductions were ordinarily miniscule.
Not until orthodontists began to
bond teeth did they consider removing larger amounts of enamel for
therapeutic purposes. Sheridan2–5
first suggested the possibility of
reducing the mesial and distal surfaces of teeth with rotary instruments, e.g., the air turbine with thin
diamond or carbide burs. The rationale was to mimic by fast, deliberate removal of enamel the natural
attrition of enamel that Begg6,7 had
discovered occurring with Australian aborigines.

Instrumentation
Most early recommendations for
reducing the mesio-distal dimensions relied on abrasive strips,
which require a maximum of labor
for minimal results. Cavitron developed a thin-bladed instrument that
combined with an aluminum-oxide
slurry to reduce enamel ultrasonically, but the ADA removed its
approval, and the company stopped
making it.
Dome Corporation developed a
rechargeable reciprocating electric
motor based on a General Electric
toothbrush. The thin abrasive tips
were made of diamond-encrusted
films or aluminum-oxide films.
The Dome Corporation stopped
production of the Dome Stripper
several years ago. This left primarily two effective mechanized instruments for quick enamel reduction:
thin rotary discs, which can cut in
one plane only and carry a high
level of danger, and the air rotor
instruments, which often remove
more enamel than necessary.

Enter the Ortho Slenderizer
The newest addition to the IPR
armamentarium, the Ortho Slenderizer™ offers orthodontists the latest automated IPR instrument and
provides an improved and more
versatile relative to the earlier version of the Dome Stripper. The
blades incorporate perforated, rapid-cutting, diamond-abrasive surfaces, which resist clogging and
exhibit no measurable heat build
up. Blades of fine, medium and
course grit reduce the drudgery of
IPR to minutes.
The contact breaker blade is half

The OrthoSlenderizer (Photo/
Provided by OrthoMatics)
blank and half abrasive. The blank
can be inserted into any tight contact, such as a piece of thin wire

floss. The abrasive is then eased
into the contact to break it. Hand
strips are now needed only with
extreme rotations.
Unlike short blades, rigid blades
or spinning disks, Ortho Slenderizer
blades can flex to produce superior
rounding of line angles. This tool is
designed for maximum efficiency
and ease of use and is an exceptional value.
Quite simply, the Ortho Slenderizer is the clinician’s best tool for
the task, i.e., reducing the drudgery
of IPR.
See the OrthoSlenderizer in
action at orthomatics.com. OT

References

1. Peck S, Peck H. Index for assessing
tooth shape deviations. Am. J. Orthod.
1972;61:384–401.
2. Sheridan JJ, Hastings, J. Air-rotor stripping and lower incisor extraction treatment. J Clin. Orthod. 1992;26:18–22.
3. Sheridan JJ, Ledoux, P.M. Air-rotor stripping and proximal sealants: an SEM. J.
Clin. Orthod. 1989;23.
4. Sheridan JJ. Air-rotor stripping update J.
Clin. Orthod. 1987;21:781–788.
5. Sheridan JJ. Air-rotor stripping. J. Clin.
Orthod. 1985;19:43–59.
6. Begg PRaK, P.C. Begg orthodontic theory
and technique. Philadelphia: W.B. Saunders Co.; 1977.
7. Begg PRaK, P.C. The differential force
method of orthodontic treatment. Am J
Orthod. 1977;71:1–39.
AD

[12] =>

Industry

Ortho Tribune | September Supplement

Edge: Experience the revolution
O
rtho2 is the largest privately
held orthodontic practice management software provider in
the world and works exclusively
with orthodontists. Now Ortho2 is
offering a new innovative and comprehensive system, Edge™.

Revolutionary and reliable
The revolutionary Edge practice
management, imaging and communications system offers your
practice private, secure cloud-computing technology. This simple, convenient feature allows you to fully
access your secure web-based data
infrastructure from anywhere, even
smart phones. With cloud computing from Ortho2, your practice can
AD

eliminate the cost, complexity and
risks associated with in-house servers and backups.

images or layouts, a simple import
and much more. Edge Imaging can
be used with all Ortho2 management systems as well as with other
management systems or by itself.
Edge Imaging works with Ortho2’s
premier imaging module to provide
ceph analysis, superimposition and
Bolton Standards overlays.

Innovative new solutions

This all-in-one solution takes practice management to the next level,
offering leading technology to
increase efficiency and profitability,
including a new Edge Imaging platform to manage high-quality patient
image files, new Edge Animations
for patient compliance and treatment videos and new Edge Reminders to make communication with
patients immediate and effortless.

Edge Imaging
Edge Imaging has everything you

Edge Animations. (Photo/Provided
by Ortho2)
would expect, as well as innovative new features such as card-flow
image presentation, drag-and-drop
layout customization, unlimited
undo and redo, silhouette image
alignment, the ability to e-mail

Edge Animations
Edge Animations is a powerful tool
for enhancing patient education,
compliance and case presentation.
Edge includes a set of patient-compliance animations at no charge and
an optional extended set of treatment-based animations. According
to Ortho2, the cutting-edge rendering techniques used produce videos
of such quality they must be seen
to fully appreciate their educational power. These animations allow
the patient and parent to experience and quickly understand many
aspects of treatment and compliance in ways that still images and
verbal descriptions can’t match.

Edge Reminders
Edge Reminders allows you to easily send messages via phone, e-mail
and/or text as desired for each
patient. Send appointment reminders or messages from a customized subgroup of folders to remind
patients about a variety of important
events such as birthdays. Define upto-the-minute start and end times as
well as retries for your reminders.
In addition, patient responses are
integrated into the Edge Scheduler
to easily see which patients have
confirmed for the day.

Comprehensive features
Edge also includes Workflows
Standardized Tasks, HR Manager,
Dynamic Dashboard and Widget
Library, Edge Reports, Goal Tracker, Smart Scheduler, Collections
Assistant and more. Edge is compatible with PCs, Macs or a mixed environment and can support multiple
monitors for a power user.

A history of success
For nearly 30
years, Ortho2
has designed,
developed and
provided software and services solely to
the orthodontic
market.
According to the company, more
than 1,600 orthodontists have discovered the company’s software,
effective conversion process, quality training, ongoing support and
optional equipment services.
From its beginning, Ortho2 has
delivered innovative and reliable
software solutions for orthodontists.
The company continues to build
upon its core business and expand
the company’s product lines to help
its orthodontic partners advance
and succeed. OT

[13] =>

[14] =>

Industry

Ortho Tribune | September Supplement

Improve your production,
profitability, quality of life
By Paul Zuelke

n many practices, less than 60
percent of exams with orthodontic treatment diagnosed ever
start. That is a much lower rate
of case acceptance than what the
profession had 30 years ago, yet
too many orthodontists have accepted today’s rate as “the norm” and
therefore believe that their only
path to growth is more exams.
A never-ending search for more
new patients is rarely the solution
to greater production or to greater
profitability. Instead, the answer is

to increase the percentage of your
new exams that start.
The responsibility of the orthodontist is to make it easy for his/
her customers (patients) to buy the
product (braces) that he/she sells
(diagnoses). However, far too many
doctors have forgotten, or perhaps
never understood, that 80 percent
of patients/parents cannot afford to
write a check for $5,000 to $7,000 in
treatment.
These practices’ financial policies, the insistence on large down
payments and short-term contracts
and the efforts to push patients into

outside financing have done more
to drive potential patients away
from the practice than any other
single factor.
Our advice to our clients since
1980 has been to be negotiable and
flexible with respect to financial
arrangements. If a $0 down payment
and 24-month — even 30-month —
financing is necessary in order to
get a patient started, and if the
responsible party is credit worthy,
then grant that type of in-office
credit to your patients.
Are you really willing to lose
a $5,000-plus case start because

OT About the author
Paul
Zuelke
is president and
founder of Zuelke & Associates,
a
management
consulting
firm
specializing exclusively in teaching
credit
management and accounts receivable control
techniques to health-care practices.
Zuelke’s extensive, professional
background in lending and corporate
finance, combined with 30 years of
experience with more than 1,000 client practices located throughout the
United States, Canada, and Australia,
position him as a leading authority in
using effective credit management to
build a quality health-care practice.

your patient/parent cannot afford
an $800 down payment or cannot
afford the payments because you
have limited your contract to 18
months?
Notice the key phrase above is, “if
the patient is credit worthy.” There
is nothing worse for the quality of
life within the practice than to get
into a negative financial relationship with a financially weak patient.
Missed appointments, poor clinical
cooperation, over-treatment time,
etc., are always the result.
So, while it makes sense to be
financially liberal with quality
patients, it is a major mistake to do
so with patients/parents who are
immature, unstable and unwilling
to or incapable of keeping their
financial agreements.
Fortunately, with modern electronics and communications, in
less than 60 seconds a practice can
make a high-quality credit decision
identifying the potential financial
risk of any given patient.
What is it worth to you to know
that the patient/parent has, for his
entire life, paid all of their bills
perfectly? What is it worth to you
to know that this person has never
paid a bill and has been sued by
every credit grantor in town?
Seventy-five percent of most
practices’ new patients are in the
low-to-zero financial risk category
— what we call “A” patients. Twenty-five percent are in the moderateto high-risk category — “B” and “C”
patients.
Take the time to find out which
of your patients are which, grant
credit proportional to that risk, and
you will improve production, profitability and your quality of life within
the practice.
Various products are available
to help you assess risk as. Consider the Zuelke Automated Credit
Coach (ZACC), which returns a letter grade and a payment-plan recommendation in seconds. This webbased tool, which was specifically
designed for orthodontists, evaluates stability, maturity and credit
integrity in exactly the same fashion
as a bank loan officer but does not
affect your patient’s credit score.
To learn more about ZACC, take
a look at www.getzacc.com. OT

[15] =>

Industry 15

Ortho Tribune | September Supplement

Align introduces Invisalign G3
New innovations represent leap forward in clear aligner therapy

lign Technology announces
the launch of Invisalign® G3,
the most significant collection
of new features and innovations in
the company’s history.
Invisalign G3 is engineered to
deliver even better clinical results,
with new aligner and software features that make it easier to use
Invisalign with Class II and Class III
patients, new SmartForce™ features
designed for increased predictability of certain tooth movements and
simpler, more intuitive software to
streamline treatment planning and
review.
Invisalign G3 builds on a new and
improved feature set introduced to
the Invisalign product line last fall.

Easier Class II and Class III
treatment

The treatment of Class II/III malocclusion often requires the use
of inter-arch elastics to provide
anchorage control. Previously, clinicians had to manually cut the
aligners to accommodate the use of
elastics.
Invisalign G3 addresses this barrier with new precision cuts, which
are doctor-prescribed pre-cuts in
the aligners that accommodate the
use of elastics. Using a new dragand-drop interface in ClinCheck 3.0
software, clinicians have the flexibility to specify the placement and
the type of precision cuts on the
aligners.

SmartForce features
SmartForce features, such as the
optimized attachments introduced
last fall, are attachments and aligner features that are engineered to
deliver the forces needed to achieve
predictable tooth movements.
Based on biomechanical principles,
SmartForce features are customized
to each tooth using advanced virtual
modeling and are positioned precisely to deliver the proper forces.
New SmartForce features in
Invisalign G3 include an optimized
rotation attachment for bicuspids
(previously available only for cuspids), a new Power Ridge™ feature for lower anteriors (previously
available only for the upper arch)
and a lingual power ridge feature
for upper anteriors.
A new variation of the optimized
rotation attachment is also being
introduced to address clinical situations where placement of the
attachment may have previously
been difficult.

ClinCheck 3.0 and the
Invisalign Doctor Site

In addition to clinical tools and
enhancements,
Invisalign
G3
streamlines the overall treatmentplanning process. Specifically, a significant evolution of the ClinCheck
software makes it easier and more
intuitive for clinicians to create and
modify Invisalign treatment plans.

Align Technology’s new precision
cuts. (Photo/Provided by Align)
One of the improvements is the
addition of drag-and-drop interfaces for ordering precision cuts and
attachments, providing clinicians

with new tools designed to make it
easier and more efficient to develop
and review treatment plans.
The Invisalign Doctor Site (formerly Virtual Invisalign Practice or
“VIP”) is a secure website where
clinicians access Invisalign patient
records, review and approve ClinCheck treatment plans, view patient
account status, order treatment supplies and more.
A significant redesign of the site
not only makes it simpler and more
intuitive to use but also consolidates
all of a patient’s Invisalign records
and treatment tasks together in one
location for easy access. The Invis-

align Doctor Site also introduces a
new online prescription form that is
integrated with the clinician’s clinical preferences.

Available soon
The improvements and innovations in Invisalign G3 also include
new clinical preferences, improved
staging for interproximal reduction
(IPR) and the addition of compliance indicators to Invisalign Assist.
Invisalign G3 features will be
available at no additional cost to
Invisalign-trained clinicians in
North America in October, with
international availability in 2011. OT
AD

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[cover] => Ortho Tribune U.S.

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