By Marc Ackerman & Ben Burris

Bob Dylan once sung “the times they are a changin’”. Learn it. Live it. Love it. Embracing change is the only way to survive in orthodontics but if you play your cards right and use your head, you can do a lot better than mere survival.  We can’t always predict the future but we sure as hell can learn from the mistakes of our past. Despite what you’ve been told, there has never been a “Golden Age of Orthodontics”. Those who pine for “the good old days” are merely self-identifying losers who can’t cut the mustard. The modern dental landscape is what it is and TODAY is what we have. Adapt and prosper.

If we’ve heard it once we have heard Paul Zuelke say dozens of times that, “nothing has changed in orthodontics in the past 30 years”. These statements (and most of the surrounding) are so ludicrous that we have just ignored them in the past but given Paul’s recent talkativeness we thought it would be interesting to put his trademark claim to the test and take a look back at orthodontics in 1989, the year “Cash or Credit” was published to compare how different things are today. Take a look at the table below for just a few examples:

1989 2016
Wearing Gloves Optional Required
Practice type Solo/one office Group/satellites
Treatment Fee Approach Orthodontist centered Consumer focused
Financing Cash All modes of payment
Down Payment 25% Low Down Payment
Billing At visit/Mailed Statements E-Bill/ACH
Treatment Time Longer Shorter
Capacity per orthodontist Lesser Greater
Referrals Dentist Patient/DTC
Appointment interval Shorter Longer
Greater percentage of cases treated by Extraction Non-extraction
Esthetic Appliance Clear plastic brackets Invisalign

Based just on this cursory survey, we think it idiotic to claim that nothing has changed in orthodontics since 1989! We know that most orthodontists and residents can reason this out for themselves but we wanted to take this golden opportunity to show in black and white that you MUST listen to what “experts” are telling you with a skeptical ear.

  • Especially when they don’t even have an orthodontic degree and have never practiced orthodontics.
  • Especially when they start their pitch with, “I’ve been doing this for 20, 30, 40 years…”!

Question everything (we do, including our own beliefs!). Use your heads. You are obviously smart and successful to have done what you have and to be where you are so trust yourself! We hope you are reading this piece and all of our others with a skeptical eye as well. We don’t want you to listen to us or take our words for it, we only hope to motivate you to ask questions and figure things out for yourselves since there is no one right way of doing anything as far as we can tell. With some effort and thought you can separate the wheat from the chaff and reap the benefits that interaction with your friends, peers, colleagues and even these alleged experts have to offer. When you do that, we all win as individuals and as a group!

The new, connected orthodontic community is unprecedented and incredibly valuable but we still must think rather than swallowing the information we are given as truth. The good news is that if there is a new technology developed, if there is threat to the specialty or if one company sues another company and in the process threatens to screw colleagues, you’ll know about it on Facebook, OrthoPundit or Twitter within an hour of the news breaking! This is much quicker than getting our news at 6 0’clock, from a printed newsletter, from the AJODO or even from the AAO E-Bulletin. If you’re stuck with a difficult case, a treatment planning dilemma, a practice management problem or even an upset momma you can turn to an online study club where your peers help you out within minutes – much faster than the wine and dine country club event every other month. Oh, wait, doesn’t that alone mean that the entire fabric of how orthodontists communicate and run our businesses is different than it was 30 years ago? Maybe we should consider the creation of The Internet a mildly important change that’s occurred during the last 30 years?

You’ll have to decide for yourself!