Orthotown June 2019 - 36

office visit

kids we see to have appliances made for and
delivered to. Intraoral photography, while
years old, has become so commonplace we
forget what it was like decades ago with film
and an SLR camera! Many hours were spent
retaking photos or, worse yet, you had to
accept less-than-ideal shots. Now, all staff
can be trained to take great photos and they
can check them instantaneously.

What is your patient
treatment philosophy?

36

JUNE 2019 // orthotown.com

What gives you the most
professional satisfaction?
Getting it done! The reason that I keep

PHOTO BY BRAD ARMSTRONG

I've seen many brackets systems over
the years, and they're continuing to become
more accurate and easier to place and tie to.
The introduction of thermal-activated wires
with broad archform is my latest trend in
the practice. I know that they're not new,
but when you've practiced for more than 25
years, it takes a bit to turn the ship. I believe
that CBCT will become the standard in the
future, allowing us to focus on not only
sagittal diagnosis but also transverse and
volume as well. As we become more adept at
superimposition of volumes, orthodontists
will trust what they're seeing.
Intraoral scanning is used daily in the
practice and we're beginning to deliver
retainers at debonding of previously scanned
images. The ability to scan for expanders and
the like is making it more enjoyable for the

Well, the basis is my "Treatment by
Twelves" philosophy, which has been
published in Orthotown and Dentaltown
magazines. It basically states that everything
we deal with in a typical patient and our
decision making is based on the eruption of
the teeth, the jaw relationship, the function
of the temporomandibular joint, and the
influence of facial muscles and airway. I then
break down patients into groups based on the
teeth erupting. Young patients ages 6 to 9
are usually getting their first 12 permanent
teeth. Adolescent patients between ages 10
and 14 are typically getting the next 12
permanent teeth. Lastly, after age 15 or so,
most permanent teeth are in, and treatment
can either be initiated and completed in one
phase or it would represent the final phase
of care.
I was never much of a Phase I treatment person, but the work of Drs. James
McNamara and Sean Carlson has really
opened up my eyes. Having adequate transverse dimension makes complete care so
much easier and predictable. The CBCT
evaluation is really allowing for planning
treatment to achieve adequate width and
make room for all of the teeth. In the past,
we were concerned with stability of these
early treatments. I still am. However, once
you understand the influence of healthy
breathing and facial musculature on the
dentition, you can really change the dental
relationship in so many patients.


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Orthotown June 2019

Table of Contents for the Digital Edition of Orthotown June 2019

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