Crossing the border (Continues on p. 5); How to whiten teeth - even underneath brackets (Continues p. 6) / Conflicts and challenges … / News / Ortho goes live in New York / Crossing the border / How to whiten teeth - even underneath brackets / Systems for increasing production: the one-appointment consultation / Industry
Crossing the border (Continues on p. 5); How to whiten teeth - even underneath brackets (Continues p. 6)
01 - 01 viewConflicts and challenges …
02 - 02 viewNews
03 - 03 viewOrtho goes live in New York
04 - 04 viewCrossing the border
05 - 05 viewHow to whiten teeth - even underneath brackets
06 - 10 viewSystems for increasing production: the one-appointment consultation
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[1] =>
ON
ED
ITI
IA
LN
ES
O
ORTHO TRIBUNE
SP
EC
The World’s Orthodontic Newspaper · U.S. Edition
October 2010
www.ortho-tribune.com
Vol. 5, No. 10
Enter and win!
Off to New York
A winning strategy
A practice makeover
could be yours
GNYDM adds ortho
courses to its lineup
Ortho2 receives award
for Edge marketing
uPage
3
uPage
4
uPage
14
Crossing the border
NESO expands
its horizons both
geographically and
educationally for its
89th annual meeting
By Kristine Colker, Managing Editor
T
he Northeastern Society of
Orthodontists (NESO) is going
international for this year’s
89th annual meeting. The four-day
event, to be held from Nov. 11–14, is
taking place at the Hilton Bonaventure in Montreal. So grab your passport and start making plans if you
haven’t already.
A view of downtown Montreal. (Photo/Provided by stock.xchng)
Blending its French accent with
that of many other ethnic communities, Montreal charms its visitors
with its Euro-American ambiance.
Once you arrive in Montreal, you’ll
discover the Bonaventure Hilton is
located in the heart of downtown.
g OT page 5
How to whiten teeth, even underneath brackets
W
ritten by three renowned
researchers and clinicians,
this article describes the use
of a new dental whitening product
based on hydrogen peroxide. The
effect of this compound whitens
dentin in multi-directional angles,
reaching areas covered by brackets
and making it possible to achieve
teeth whitening under braces.
Patients are willing to use this
whitening procedure, both in-office
and at home, because they want to
achieve white teeth while under
orthodontic treatment.
The result is a whitening technique that also achieves a marked
Dental Tribune America
116 West 23rd Street
Suite #500
New York, NY 10011
By Dr. Enrique Jadad, Dr. Jaime Montoya
and Dr. Gonzalo Arana Gordillo
described a technique for daily use
in 1989 that used a low carbamide
peroxide concentration to remove
deeper teeth stains, which increase
with patient’s age.2
Dental whitening popularity
Fig. 1: Patient under orthodontic
treatment. (Photos/Provided by
Dr. Enrique Jadad)
increase in patients’ oral hygiene
habits.
The use of hydrogen peroxide as
a dental whitening agent was first
described by Kingsbury in 1861.
The dentists’ desire to provide
fast and effective teeth whitening
procedures was described by Abbot
in 1918, when he introduced a wonderful and revolutionary in-office
dental whitening, a 35 percent,
hydrogen-peroxide concentration
that, together with heat emission
from a lamp, increased oxidation.1
Drs. Haywood and Heymann
The success of hydrogen peroxidebased teeth-whitening products
have been historically accepted and
validated by research.
Messages on TV, newspapers,
magazines and other media have
popularized dental pigments and
removal of teeth stains caused by
age, food, beverages with colorants,
cigarettes and tea, among others. People ask for dental whitening treatments to achieve a better
esthetic and improve their smile
and their self-esteem, all of which
are closely related to serious dental
pigmentation factors.3
The successful use of H2O2 for
dental whitening, using different
techniques for in-office and at-home
treatment, has been described by
many authors.4
g OT page 6
PRSRT STD
U.S. Postage
PAID
South Florida, FL
PERMIT # 764
[2] =>
2
From the Editor
Ortho Tribune | October 2010
Conf licts and
challenges …
By Dennis J. Tartakow, DMD, MEd, PhD,
Editor in Chief
‘To present an
adequate discussion
of these challenges,
postgraduate orthodontic
programs should
consider appropriate and
problem-specific training
for the orthodontic
resident.’
• addressing performance of others
perceived to be inappropriate.
D
octors are trained to diagnose
and treat ill health. Within the
confines of the doctor/patient
relationship, most clinicians perform this role successfully.
The traditional role of the orthodontist is carried out within a
broader historical, organizational,
social and political context — where
the diagnosis and treatment can be
as important as clinical interactions
with individual patients.
Unless we are willing to understand and influence this wider context, our ability to improve health
outcomes in an increasingly complex environment will be challenged.
According to Hockey and Marshall (2009), this understanding
can be achieved by engaging with
the emerging science of quality
improvement, comparing current
practices with an approach that
focuses on patients as well as the
wider health system.
Rosenbaum Bradley, Holmboe,
Farrell and Krumholz (2004) suggested five categories of ethical
conflict faced by young doctors:
• concern over telling the truth,
• respecting a patient’s wishes,
• preventing harm,
• managing the limits of one’s competence, and
Tell us
what
you
think!
Literature reviews construct a
more comprehensive classification
of types of the ethical challenges.
To present an adequate discussion
of these challenges, postgraduate
orthodontic programs should consider appropriate and problem-specific training for the orthodontic
resident.
An appropriate ethics curriculum, necessarily constrained by the
demands of clinical practice and
research, should give priority to the
real-life issues that residents will
encounter in his or her practice. A
strong emphasis on the types of ethical problems in addition to the classic bioethical dilemmas would best
equip graduates for the challenges
of life as clinical practitioners.
Human rights issues can thus
serve as a useful resource for educators of ethics and laws involved in
curriculum development.
We all must engage with quality
improvement as part of good orthodontic practice. Quality concerns
in orthodontics are not just about
the many outcome objectives and
assessments; it is primarily concerned with health-care processes,
including education, patient safety,
decision-making, relationships with
patient, etc.
While I am a fan of problem-based
learning (PBL) to some extent, and
evidence-based medicine (EBM) in
Do you have general comments or criticism you
would like to share? Is there a particular topic you
would like to see more articles about? Let us know
by e-mailing us at feedback@dental-tribune.com.
If you would like to make any change to your
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send us an e-mail at database@dental-tribune.
com and be sure to include which publication you
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changes can take up to six weeks to process.
general, EBM may not offer guidelines for what processes one must
adopt in order to achieve its goals
(Hockey and Marshall, 2009).
Research often attempts to define
the best medical treatment or surgical intervention. However, the processes that clinicians go through to
incorporate evidence into care are
equally as critical.
Ultimately, evidence is translated
into patient outcomes and the quality of health-care must be of concern to all clinicians. The latest
technology available is like the
daVinci robot, but reaching a good
quality decision about the right
treatment for a specific patient
involves teamwork in the office,
patient safety and consideration for
the patient’s experience, and are all
equally as crucial in achieving a
desirable outcome. OT
References
1. Hockey P. and Marshall M. (2009).
Doctors and quality improvement.
Journal of the Royal Society of
Medicine. 102, 173–176.
2. Rosenbaum, J.R., Bradley, E.H.,
Holmboe, E.S., Farrell, M.H., and
Krumholz, H.M. (2004). Sources of ethical conflict in medical
housestaff training: a qualitative
study. American Journal of Medicine, 116, 402–407.
OT
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
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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] =>
Ortho Tribune | October 2010
News
3
Something for everyone
DTSC Symposia coming
to Greater N.Y. Dental Meeting
P
eople from around the world
flock to the annual Greater N.Y.
Dental Meeting and for very
good reasons beyond the fact there
is no registration fee.
Dental Tribune has partnered
with the meeting’s organizers to
offer four days of symposia in various areas of dentistry.
Each day will feature five individual, one-hour lectures led by experts
in the field. The final day features
the Osseo University Summit.
Participants not only earn C.E.
credits but also gain an invaluable
opportunity to learn diverse aspects
of dentistry and how to integrate
a variety of treatment options into
their practice.
For exact program details, check
the schedule under www.DTStudy
Club.com/gnydm.
The symposia are free for registered Greater N.Y. Dental Meeting attendees, but pre-registration is
recommended. Also, because of limited seating, register early to ensure
preferred seating.
For event registration, visit www.
gnydm.com. OT
The DTSC
Symposia
schedule
for the
first three
days
of the
Greater
New York
Dental
Meeting.
AD
Apply for the
2011 Levin
Group ortho
makeover
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.
Whether you are in the beginning stage of your career or
already experienced and successful, growth is 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.levin
grouportho.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
GNYDM Preview
Ortho Tribune | October 2010
Ortho goes live in New York
TAD program
tops the agenda
T
his year, the Greater New York
Dental Meeting (GNYDM) is
offering orthodontic specialty
programs throughout its full-day
event from Nov. 28–Dec. 1. At this
exclusive series, attendees will
learn of the latest trends and techniques in orthodontics.
A unique live demonstration of
orthodontic temporary anchorage
device (TAD) technology will be
among the broad range of educational programs.
AD
The GNYDM introduces and
redefines its programs each year
to inspire the entire dental team to
excel in their profession. This year,
various world-renowned speakers
and clinicians will discuss such topics as new advances in orthodontic patient treatment, pediatrics,
mechanics and technology.
Drs. Jay Bowman and Elliott
Moskowitz will be among the various speakers from New York University’s College of Dentistry and
Orthodontic Alumni Association,
who will be speaking on Tuesday,
Nov. 30, and Wednesday, Dec. 1.
Both seminars will present a selection of innovative anchorage appli-
A scene
from last
year’s
orthodonic
specialty
program
during the
Greater
New York
Dental
Meeting.
(Photo/
Provided
by
GNYDM)
cations and auxiliaries for various
malocclusions.
At these events, attendees can
become acquainted with a multitude
of multi-tasking options, including
mini-screws and the application of
pure skeletal anchorage for molar
distalization.
Dr. John Halikias, the GNYDM’s
general chairman, said he feels
these “sophisticated and grand programs” are what continuing education really means.
“We strive to offer these unique
seminars and hands-on workshops
so that oral healthcare practitioners
at all levels of education can excel
in their profession and specialty,”
Halikias said.
On Wednesday, Dec. 1, Bowman and Dr. Jonathan T. Perry will
present a live demonstration of the
placement and activation of TADs.
This program will include the benefits of incorporating the use of
TADs and implants into traditional
orthodontic treatment modalities.
“New ideas are a welcomed addition to the educational programs
at the Greater New York Dental
Meeting,” said Dr. Robert Edwab,
executive director of the GNYDM.
“By expanding to two live dentistry
arenas, we are able to revamp oral
health care education.”
In addition, the GNYDM is again
partnering with Align Technology to
offer the Invisalign Expo. This array
of educational courses extends for
four days, beginning Sunday, Nov.
27.
Taught by the seasoned team of
Invisalign specialists, dental professionals will learn logistics of tooth
alignment, including treatment for
Invisalign crowding cases and other
orthodontic abnormalities.
There
is
never
a
preregistration fee for attending the
GNYDM. Attendees can register
for orthodontic courses by visiting
www.gnydm.com. Click “Courses
and Events” and scroll through the
course topics to view additional
information about the orthodontic
specialty seminars and workshops
offered at this year’s meeting.
For more information, call the
GNDYM at (212) 398-6922 or e-mail
info@gnydm.com. OT
[5] =>
Ortho Tribune | October 2010
f OT page 1
Historic Old Montreal is a short
walk away. Head up to Sherbrooke
Street or St. Catherine’s Street for
world-class shopping and dining.
On the way, find museums or casinos. Montreal has something for
everyone.
Of course, it wouldn’t be an annual session if there weren’t also a
chance to expand your educational
horizons.
This year, Dr. Ron Roncone headlines the doctor’s program, Dr. Duncan Higgins will present the latest
information on the X-bow appliance,
and Dr. Robert Miller will discuss
TADs and Cl 2 Correction.
Other speakers include Drs.
Steven Lindauer, David Paquette,
Nicole Scheffler and Sean Carlson.
For residents or those who are
new to the orthodontic profession, a
special program will be held for you
on Thursday, Nov. 11.
Rosemary Bray will present
“Wadda Ya Mean I Don’t Talk So
Good?”, a program focusing on communication in an effective, professional manner. She will explore
some of the most common areas of
miscommunication and share easy
to remember alternatives to assist
you in presenting a more polished
image of your practice and of yourself.
For team members, there are a
number of sessions geared specifically to your interests, starting with
Bray giving tips on extraordinary
service and, later, giving pointers on
the ultimate ortho team.
Other speakers include Rita
Bauer discussing creating outstanding marketing materials, Michelle
Macedonio with tips for smart eating to stay healthy, Elizabeth Barrett
sharing communication and presentation skills and Paul Reisman with
something just for the administration staff.
In case you don’t want to spend
all day in sessions, there are also
a few social activities as well. The
most prominent one is the President’s Gala Reception, which takes
place from 7–10 p.m. Saturday, Nov.
13 at Le Windsor.
The Le Windsor is a real-estate
landmark situated in the heart of
Montréal. It is a heritage building
dating back to an era when architects were still inspired by the great
European classics and when interior
details were still fashioned by craftsmen.
Le Windsor has been host to international guests, celebrities, dignitaries and monarchs for more than a
century: Prince Louise and the Marquis of Lorne, John A. Macdonald,
Sarah Bernhardt, Mark Twain, Stephen Leacock, Winston Churchill,
King George VI and Queen Elizabeth, Charles de Gaulle, Princess
Elizabeth and Prince Phillip and
John F. Kennedy are just a few of
the most recognizable names.
There is no fee to attend the gala
for registered participants, but a
ticket will be required, so make sure
to pick one up at the Bonaventure
Hilton ahead of time. OT
NESO Preview
5
Exploring Montreal
A guide to the sights
you’ll most want to see
A
multi-cultural city, Montreal is
the second largest city in Canada and the largest French-speaking
city in the world outside of France.
So when you’re done with the
exhibit hall and the seminars for
the day, why not check out a few
sights the city has to offer?
Do you like museums? Montreal
has many diverse offerings, including the Musée des Beaux-arts and
the Biodôme de Montréal. Found-
ed in 1860, Musée des Beaux-arts
(1380 Sherbrooke Street W.) was
one of the first museums in North
America to amass an encyclopedic collection worthy of the name.
Since then, its holdings have grown
to almost 35,000 objects, including paintings, sculptures, works on
paper, prints and drawings, photographs and decorative art objects.
The mission of the Montréal Biodôme is to increase public
knowledge of nature and related
disciplines and to promote responsible environmental behavior. To
do this, the museum (4777 avenue
Pierre-De Coubertin) re-creates
some of the most beautiful ecosystems of the world, including
everything from tropical forests to
the polar ice caps.
In addition, other popular sites
to check out include Old Montréal and the Old Port, which are
full of shopping and fine dining;
Olympic Stadium; Ste-Catherine
Street, the main commercial street
downtown; and “Reso dans la ville
souterraine” (City Underground), a
30-kilometer network of boutiques,
cafes, theatres, hotels, shopping
centers and even a university.
AD
[6] =>
6
Trends
Ortho Tribune | October 2010
Fig. 2: Close up of patient under
orthodontic treatment.
Fig. 3: Tres White Ortho ready to be
used.
Fig. 4: Tres White Ortho tray in the
upper maxillary.
Fig. 5: Removing the external
bleaching tray allows the internal
bleaching tray to stay in position.
f OT page 1
and dental pigmentation alterations
caused by bacterial plaque accumulation around orthodontic devices,
such as brackets, bands and arches,
which could lead to the decalcification processes and to long-term
adverse factors. These are often
caused by poor oral hygiene.
Conventional home care includes
tooth brushing (mechanical or
manual), irrigation devices, fluoride
mouth rinses, topical fluoride applications and dental floss usage. But
even with all this armamentarium,
there is a low motivation.5
The vast majority of these devices
and techniques used for oral-health
hygiene are not implemented by the
majority of patients, and therefore,
benefits and results are not really
significant. We should emphasize
other alternatives that, added to
the described above and together
with patient awareness, could help
us improve oral health of patients
undergoing orthodontic treatment.
Patients under orthodontic treatment are convinced they must
maintain their oral health regarding color and esthetics. Clinicians
and patients understand there is
the possibility of gingival irritations
AD
Health and esthetics
Oral health and hygiene are important factors to keep in mind for
patients who are being treated
with orthodontic devices; excellent
hygiene is associated with the need
for appropriate dental esthetics during and after treatment.
Appealing to this desire for optimal esthetics, we can implement
parallel treatments that will maintain optimal periodontal health and,
at the same time, protect teeth by
increasing teeth enamel microhardness and making them less
decay-prone. This is possible thanks
to the new dental whitening that
contains fluoride and potassium
nitrate ions in its formula.5
For these patients, we have
developed a product called Opalescence TresWhite Ortho (Ultradent,
Opal Orthodontics, South Jordan,
Utah) that prevents decalcification
because of bacterial attack, which is
responsible for carious lesions, and
also increases teeth enamel microhardness.
TresWhite Ortho comes with an
entrenched external tray for home
or in-office use and is easily adaptable to teeth and brackets topography. This flexible tray contains an 8
percent concentration of hydrogen
peroxide, fluoride and potassium
nitrate dosage.
The flexible tray containing
hydrogen peroxide should be kept
on the brackets for a 45-minute
period to achieve adequate contact
time between whitening gel, teeth
and brackets. After each 45-minute
daily session, the soft tray is easily
removed from the mouth and discarded, and the patient removes gel
remnants by brushing.
TresWhite Ortho is the first dental whitening method that works on
fixed orthodontic devices and on
preventing enamel demineralization.
Hydrogen peroxide’s bacterial
and plaque removal and gingival
tissue healing or scarring effectiveness was proved more than 35 years
ago.6,7,8,9
g OT page 8
[7] =>
[8] =>
8
Trends
Ortho Tribune | October 2010
Fig. 6: Upper and lower bleaching
trays in position with hydrogen peroxide in close contact to the teeth.
Fig. 7: After 10 days of whitening
treatment, we start the removal of
orthodontic devices.
Fig. 8: With the wires off, the
brackets themselves are now ready
to be removed.
f OT page 6
ing they need a dark, warm and
oxygen-free environment to survive
because their organisms are unable
to discard or detoxify in the presence of oxygen radicals.10
Nascent oxygen hydrogen peroxide’s conversion causes tissue and
oral environment oxygenation and
subsequently creates an inadequate
environment for bacteria growth
and reproduction.
Bacteria such as Streptococcus mutants and Lactobacillus are
responsible for enamel demineralization white spots. Both types
of bacteria are anaerobic, mean-
Fig. 9: Notice teeth color where the
bracket was after first bracket is
removed.
Overcoming reluctance
Many young and adult patients
AD
Fig. 10: Regular color under bracket;
no color differences were found.
Fig. 11: Color matching using the
VITA Easy Shade spectrophotometer.
Fig. 12: Color matched, B2, showing
in the Easy Shade screen.
are reluctant to wear fixed orthodontic brackets because of their
unattractive esthetic appearance.
Adequate oral hygiene is more difficult to achieve when wearing these
devices, and after months or years
of treatment, patients’ teeth can
become dark or pigmented, thus
increasing patient rejection to orthodontic treatments.
The use of already medicated,
adaptable and malleable trays for
home or in-office treatment is an
excellent and easy way to provide
patients the opportunity to have
sparkling white teeth during orthodontic treatment.11
TresWhite Ortho’s hydrogen
peroxide conversion to oxygen is
highly beneficial for eliminating
g OT page 10
[9] =>
[10] =>
10
Trends
Ortho Tribune | October 2010
f OT page 8
gingivitis because of the ability to
provide extra required oxygen during high-oxygen consumption by
the inflamed gingival tissues.12,13
TresWhite Ortho whitening
power has an additional and predictable benefit. Hydrogen peroxide
has a low molecular weight of 32
mg/m, which allows its easy diffusion through enamel to dentin.12
Once it spreads to the dentin,
oxygen molecules act upon the dark
pigments, rotating and fragmenting
them, creating a whitening effect in
the dental structure.14
Hydrogen peroxide whitens polydirectionally inside the teeth, even
underneath places covered by orthodontic devices such as brackets,
making it possible to obtain homogeneous whitening on patients
wearing orthodontic devices.12
Additionally, dental whitening increases the responsibility for
maintaining good oral hygiene. An
18-year-old patient is more receptive to a treatment based on a dental
whitening product than to brushing
with fluoride toothpaste or using
anti-plaque mouth rinses.
This is quite evident when
removing the soft TresWhite Ortho
tray, since teeth must be vigorously brushed to remove the viscous
hydrogen-peroxide based whitening gel remnants.
The result is chemical and
mechanical removal of filaments
and bacteria from the teeth surface
and brackets.
As oral-health professionals,
we desperately work to increase
patient’s awareness for functional,
healthy and esthetic orthodontic
treatments.
TresWhite Ortho is effective in
removing bacteria and achieving
enamel hardness, leaving patients
with white, bright and sparkling
teeth. But more importantly, it
leaves teeth healthy and fissurefree.
This type of result must be our
new maintenance and care methodology for modern orthodontic therapies. OT
References
1. Fassanaro TS. Bleaching teeth:
History, Chemicals and Methods used for common tooth
discoloration. J Esthet Dent 1992;
4: 70–78.
2. Haywood VB, Heymann HO.
Nightguard vital bleaching. Quintessence Int 1989; 20:173–6.
3. Hein DK, Ploegger BJ, Hartup JK,
et al. In-office vital tooth bleaching — what do lights add? Compend Contin Educ Dent 2003;
24(4A):340–52.
4. Haywood VB. History, safety and
effectiveness of current bleaching
techniques and applications of the
nightguard vital bleaching technique. Quintessence Int. 1992; 20:
471–488.
5. Proffit WR, Fields HW Jr, Sarver
DM. Contemporary Orthodontics,
4th ed. St Louis, Mo: Mosby Elsevier; 2007:66.
6. Reddy J, Salkin L. The effect of
Fig. 13: Color matching using the
Classic Vita Guide Lumin Vacuum.
Fig. 14: Final result after 10 days
usage of Tres White Ortho and
brackets removal.
Fig. 15: Patient smile shows uniform
color in all the anterior teeth.
Figs. 16–18: Ultradent’s
TresWhite Ortho whitens
teeth under fixed orthodontic
treatment.To use the product,
insert the unique double-tray
(Fig. 16) into the mouth.
The external tray quickly
aligns and positions the soft,
thin, internal bleaching tray.
Remove the external tray
(Fig. 17). The internal tray
comfortably adapts to any
bracketed arch. The tray is
loaded with an 8 percent
hydrogen peroxide solution,
which travels through the
enamel to bleach behind
brackets. Leave the tray in
for up to 60 minutes
(Fig. 18).
Fig. 16
Fig. 17
a urea peroxide rinse on dental
plaque and gingivitis. J Periodontol 1976; 47:607–610.
7. Shapiro W, Kaslick R, Chasens
A, Eisenberg R. The influence of
urea peroxide gel on plaque, calculus and chronic gingival inflammation. J Periodontol 1973:44:636–
639.
8. Fogel M, Magill J. Use of an
antiseptic agent in orthodontic
hygiene. Dent Survey 1971 October: 50–54.
9. Zinner D, Duany L, Chilton N.
Controlled study of the clinical
effectiveness of a new oxygen gel
on plaque, oral debris and gingival inflammation. Pharmacol Ther
Dent 1980; 1:7–15.
10. McCord JM. An enzyme-based theory of obligate anaerobiosis: the
physiological function of superox-
Fig. 18
ide dismutase. Proc. Nat. Acad. Sci.
USA. 1971; 68:1024–1027.
11. Morgan J, et al. Orthodontics with
a twist. April-May 2007. www.
orthodonticproductsonline/issues/
articles/2007-04_08asp.
12. Haywood V, Parker M. Nightguard
vital bleaching: how safe it is?
Quintessence Int 1991; 22(7):515–
523.
13. Stephan RM. The effect of urea
in counteracting the influence of
carbohydrates on the PH of dental
plaques. J Dent Res 1943: 22:63–71.
14. Sulieman M. An overview of
bleaching techniques: 1. History,
chemistry, safety and legal aspects.
Dental Update 2004; 31:608–616.
15. Kielbassa AM. Tooth bleaching-increasing patients’ dental awareness. Quintessence Int
2006:37(9):673.
OT Contact
Dr. Enrique Jadad, DDS, is a
specialist in oral rehabilitation and
an associate professor at Cartagena
and Santiago de Cali Universities
in Colombia. He is also an international visiting professor at Viña del
Mar University, Chile. Contact him at
ejadad@gmail.com.
Dr. Jaime Montoya, DDS, is an
orthodontic specialist in private practice in Barranquilla, Colombia. Contact him at jamontoya72@gmail.com.
Dr. Arana Gordillo is a professor
at Santiago de Cali University and a
researcher in esthetics and biomaterials who leads the BEO Research
Group. Contact him at gonzalo.
arana@usc.edu.co.
[11] =>
[12] =>
12
Practice Matters
Ortho Tribune | October 2010
Systems for increasing production:
the one-appointment consultation
By Roger P. Levin, DDS
T
he most effective way to
increase practice case acceptance and decrease the incidence of patient shopping is the
one-appointment process. It is
important to understand that each
minute of the consultation appointment must be carefully planned,
systemized and executed.
The process about to be described
has been used in hundreds of orthodontic practices enrolled in Levin
Group’s consulting program. The
AD
result is usually a 90 to 95 percent
case acceptance rate using the oneappointment process.
The basic steps for implementing
the consultation are:
• Start strong. A warm greeting
during the initial telephone call
with effective scripting is recommended. Remember, case presentation starts at the first phone call
— not at the consultation. To dissuade patients from ortho shopping, schedule all new patients
within seven to 10 days.
• Designate a “practice ambassa-
dor.” An orthodontist’s time is
best spent chairside treating
patients. Using a treatment coordinator allows the practice to
focus exclusively on the patient
without taking up too much of
the doctor’s time. A well-trained
treatment coordinator can handle
most of the consultation, leaving the orthodontist more time to
spend on productive patient care.
• Make it personal. Most parents
make a decision about orthodontic care based more on their overall feeling about the orthodontist,
staff and office. Asking questions
about the patient’s background
is key to creating a strong relationship. Subjects of interest can
be school, athletics and extracurricular activities.
• Emphasize benefits and results.
Discuss the treatment plan in
terms of patient benefits and
esthetic results. Describe the recommended treatment — but don’t
overwhelm patients and parents
with clinical details. Emphasizing
benefits is critical to motivating
parents (and patients) to accept
recommended treatment. Keep
in mind that most parents are
more concerned with the final
esthetics that will be achieved for
their child than with the process
involved to get there.
• Inspire confidence. The orthodontist also needs to answer any
questions, inspiring confidence
and enthusiasm in the recommended treatment.
• Finalize the presentation. Upon
answering patient questions, it
is time for the treatment coordinator or financial coordinator
to handle financial matters. The
clinician’s time should be limited
to treatment issues.
New patients drive ortho success.
Convert more ortho shoppers into
patients with the one-appointment
consultation process. OT
To jumpstart practice growth,
get a free excerpt from Dr. Roger
Levin’s new book, “How to Create
and Run A Highly Successful Ortho
Practice.” E-mail customerservice@
levingroup .com with “Ortho Tribune
Free Excerpt” in the subject line.
OT About the author
Dr. Roger P. Levin is chairman
and chief executive officer of Levin
Group, the leading orthodontic practice management firm. Levin Group
provides Total Ortho Success™, the
premier comprehensive consulting
solution for lifetime success to orthodontists in the United States and
around the world. Levin Group may
be reached at (888) 973-0000 and
customerservice@levingroup.com.
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14
Industry
Ortho Tribune | October 2010
Ortho2 awarded Silver Summit award
for marketing communication excellence
O
rtho2, a leader in orthodontic practice management,
imaging and communication
solutions, has received the prestigious 2010 Silver Summit Marketing Effectiveness Award for the
Edge system launch campaign at
the Summit International Awards.
The Summit Award recognizes
creative excellence and marketing
effectiveness.
The campaign generated interest for the Edge system through
print collateral, online resources
and tradeshow assets. Ortho2 was
in consideration with 544 entries in
The Edge Animations. (Photo/
Provided by Ortho2)
the healthcare/medicine category.
“Our message was simple: revolutionary technology can offer a
better solution,” says Dan Sargent,
president and co-founder. “This
award is icing on the cake in our
ongoing commitment to help orthodontists succeed.”
The Edge system is a comprehensive practice management solution that offers features, such as an
off-site data hosting option, imaging, patient education animations,
appointment reminders, patient
online access and more, to build a
thriving orthodontic practice.
About Ortho2
For nearly 30 years, Ortho2 has
designed, developed and provid-
ed 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. The company
continues to build upon its core
business and expand its products.
For more information, contact
Ortho2 at (800) 678-4644 or visit
www.ortho2.com. OT
AD
topsOrtho
version 4.0
released
tops Software is pleased to
announce the release of topsOrtho™ version 4.0, a significant
update to the company’s flagship
product.
topsOrtho is a leading Macbased practice management and
imaging system for orthodontics. Version 4.0 boosts the system’s data speeds by as much as
500 percent with no sacrifice in
image quality.
Customers will see dramatically faster image loads, patient
chart loads and nightly rollovers,
even when working in a satellite
or home office.
“topsOrtho’s legendary speed
and stability are what our customers value most, so we constantly work to strengthen those
attributes,” said Michael Ledford, who spearheaded programming for the year-long project.
In version 4.0, image editing
is greatly enhanced. topsOrtho
now automatically scales images
being imported, so users no longer need a supplemental program. In addition, new tools provide quick, consistent editing.
“Imaging may be our bestkept secret,” said tops Software
Founder and CEO Dr. Mark Sanchez. “topsOrtho is the only orthodontic practice management
software with built-in imaging.
Our customers don’t have to buy
— or pay support fees for — an
image editing program.”
Version 4.0 also allows topsEcho™, the upcoming iPhone
app for topsOrtho customers, to
quickly retrieve quality patient
images over an ordinary cell
phone connection.
For more information, visit
topsOrtho.com or call (888) 7702488.
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News
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Ortho goes live in New York
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How to whiten teeth - even underneath brackets
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Industry
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