specialty selling: orthodontics
Profession of Smiles
Robert Bray, DDS, MS, may be unusual in that he knew from the time he was in sixth grade in Philadelphia that he wanted to be an orthodontist. But he may not be all that unusual - as far as orthodontists go - in how he views his chosen profession. In a word, "enthusiastically."
"I am doing something I love to do," says Bray, who practices orthodontics in Atlantic City, N.J., and who serves as the current president of the American Association of Orthodontists. As an orthodontist, "you help people. You take someone who is not very proud of their smile, and you change that. There may be issues of self-esteem, but at the end of 18 or 24 months, they’re a different individual.
"At the same time, you’re interacting with individuals [particularly young people] who are growing and changing, and you’re truly able to have an effect on their lives, and on what they’re thinking and doing," adds Bray who treats quite a few adults as well. "It’s stimulating. You’re in an environment where people want to be, and you see them often over a two-year period. You get to form relationships with them."
Above all, orthodontics offices are pretty upbeat places to be, he says. "People are smiling, they’re happy. Music is playing. It’s a place where people feel good. And we’re always updating and changing things."
More than cosmetics
Orthodontists are in the business of creating beautiful smiles by bringing teeth, lips and jaws into proper
alignment. While much of the payoff of braces is cosmetic, it’s also about straightening teeth, so that they are easy to clean and maintain, and more likely to last a lifetime. What’s more, straight teeth contribute to healthy gums, and they help individuals bite, chew and even speak more effectively.
Orthodontists receive two to three years specialized training beyond dental school. Approximately 95 percent - or 9,500 - educationally eligible orthodontists in the United States are members of the American Association of Orthodontists. Board certification is voluntary and separate from education. Approximately 5,000 AAO members are board-certified. The boarding organization is the American Board of Orthodontics, which is recognized by the American Dental Association and sponsored by the AAO.
The number of orthodontists in this country is limited by the number of slots available at orthodontics schools - anywhere from 360 to 380 annually. (Bray himself teaches classes at Temple University.) That means that at any given time, approximately 800 individuals are in training. Not all will practice in this country, however, according to AAO. Many are international students who will return to their countries to practice.
Growing demand
But the need for orthodontists is strong. In 1989, approximately 3.5 million people - both kids and adults - sought orthodontic treatment, according to the AAO. In 2006, the last year for which data is available, that number climbed to 5.269 million. Of that number, approximately 1.175 million - or one in five - were 18 or older.
"In the future, I see nothing but upside [for the orthodontics profession], says Bray, whose patient load is almost 40 percent adult. "More and more people are coming in every day concerned about how they look. And the increase in adults [seeking orthodontics treatment] is something we’re seeing as a long-term trend." What’s more, nervous parents and adult patients should be aware that the cost of orthodontics care has gone up very little over the past 20 years, he adds.
Technological advances
Like other dental specialties, orthodontists must stay up to date from a business and clinical perspective, says Bray, who, with a partner, operates four offices in New Jersey. "We’re paperless," he says. "All our images are on the computer." Patients are notified of appointments via text or e-mail messages, or by phone calls that are automatically generated.
On the clinical side, 3D imaging is a valuable asset for orthodontists, who can use the technology to identify impacted teeth and draw up treatment plans, says Bray. Brackets are smaller than in the past, and some are ceramic. Bonding materials are better, arch wires are more flexible, and the amount of hardware associated with braces is less bulky and cumbersome than in years past. "It’s very efficient, clean-looking," he says. A new technology - temporary anchorage devices, or TADs - allows orthodontists to move teeth in the desired direction without affecting adjacent teeth.
Dealing with the downturn
It’s true that orthodontists and their patients have been affected by the current economic downturn, says Bray. "No doubt everyone is feeling the effects. And orthodontists are sensitive to that." Many are offering their patients affordable payment plans, and adjusting how much money patients must put down for their initial payment.
"Families always worry about their children, so they still try to do for their kids," he says. "If their kids need a better smile, they’re willing to take care of it. But they need different terms. And we try to be sympathetic."
To succeed in the future, orthodontists will have to continue to do a few things, says Bray. First, they must stay in touch with new clinical and technological developments. For that reason, continuing education is important. Second, they must ensure that their staff stays current, through lunch-and-learns, professional meetings, and the like. "Just as with any team, we need everybody to be well-versed and knowledgeable about what is going on."
And finally, they must continue to provide the highest-quality care available. That calls for a combination of clinical expertise and empathy. "We have to always be concerned about how our patients feel," says Bray. "It’s worrying about the person who comes in."
Suppliers’ perspective
Kevin Hays, vice president of sales for Miltex, echoes many of Bray’s comments. The economic downturn has forced some patients to stay away from dental practitioners, he says. Given the current credit crunch, some people are finding it difficult to finance a set of braces for their kids or themselves. "And we haven’t seen the bottom."
Orthodontists can weather the storm a few different ways, believes Hays:
- First, they should align themselves with top-quality general practitioners. Advertising in a school newsletter or brochure won’t generate near as much pull-through as a referral from a respected general practitioner, he says.
- Second, they should continue to improve the business side of their practices. Implementing practice management software is an excellent way to do so.
- Third, they need to keep pace with clinical technology. New imaging techniques, for example, not only help the orthodontist provide better care, but they also help him or her explain the proposed care plan to the patient. "That’s a big change," says Hays. "[As a patient], I want to know exactly what’s going on if I’m dropping $200 a month" for my care.
At the same time, distributors of dental products and equipment need to be asking themselves how they can help their customers be more efficient, says Hays. Can they help them secure the credit they need to purchase equipment to improve their practices? Can they help them select products to make them more efficient?
Sidebar:
Orthodontists help those in need
The economic downturn has tested the ability of families to provide their kids - or adults - with proper orthodontic care. "The most important thing for us - as an organization [that is, the American Association of Orthodontists] and as individuals - is to continue to make sure we can help those who cannot [otherwise] receive care," says Robert Bray, DDS, MS, current president of the AAO. "But I’m not aware of an orthodontist who doesn’t help children or adults who can’t receive care [without it]."
In fact, the AAO estimates that collectively, its members provide more than $62 million in free and discounted treatment each year to those in need. According to the association:
- Eighty-seven percent of practicing members provide free or discounted treatment to those in need.
- The majority provide more than $10,000 in pro bono, free and discounted treatment annually.
- Ten percent provide more than $20,000 in pro bono, free and discounted treatment annually.
In addition to the free or discounted care they provide on their own, some AAO members donate their services through the "Smiles Change Lives" program and the Smile for a Lifetime Foundation.
Recently, the AAO launched a new program to enable orthodontists to provide donated treatment to children whose families otherwise could not afford it. Administered through the National Foundation of Dentistry for the Handicapped (NFDH), the Donated Orthodontic Services (DOS) program will be piloted in five states over the next two years - Rhode Island, Illinois, Indiana, Kansas and New Jersey. More than 600 AAO members already participate with the NFDH in providing donated treatment for permanently disabled individuals and seniors.
Participating orthodontists will provide donated treatment for at least two child patients per year. NFDH will handle screening and referral of patients and provide ongoing coordination of services.
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