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Plenty of our readers (55%) have indicated a desire to incorporate more orthodontic services into their general practices, according to the results of our latest poll. And why not? After all, orthodontic care isn’t just for kids anymore.

More and more adults are seeking a straighter smile, and many of them are choosing newer, more esthetic forms of tooth movement, including clear aligner treatments, lingual orthodontic treatment (tongue side of the teeth), and forms of “accelerated orthodontics” for those patients who seek quick results.

While the demand for adults seeking a straighter smile is on the rise, GPs also need to stay on top of the field in order to diagnose and treat patients of varied ages. Some of you serve patients due to limited access to orthodontists in your area, while some of you may just want to expand your services to include more ortho. And even if you don’t fall into either one of those categories, you’ll still want to be able to make informed referrals to orthodontists.

In our latest Orthodontics Survey (see “About this survey,” page 65), we ask our readers to tell us what ortho services they provide, how their caseload has changed, and also how they feel about things like the profitability of ortho, their desire to provide more ortho, and whether dental schools should teach simple tooth movement and early intervention techniques.

In the article, International Association for Orthodontics (IAO) President Dr. Kenneth Gasper shares his insight on our survey and the future of orthodontics, and Drs. Lou Shuman and Jaimee Morgan provide information on some of the increasingly popular “invisible” aligner treatments as well as continuing education suggestions for GPs who are looking to stay informed on the latest happenings and treatment options available to their patients.

More ortho

Twenty-eight percent of you report an increase in the size of your ortho caseload over the past 5 years (see “Caseload changes,” page 61), while just 5% report a decrease.

Dr. Gasper believes that a larger number of GPs should be providing at least some type of orthodontic treatment to their patients. This is critical, he feels, when dealing with younger patients.

“It is important to develop the knowledge and skills to diagnose and identify issues related to facial growth and development in order to provide corrective solutions during those critical growth years between the ages of 5 to12 years of age,” Dr. Gasper said. “This may be as simple as diagnosing critical airway concerns that may negatively impact proper facial growth and development of our young patients. Minor orthodontic corrections may be helpful and even necessary prior to esthetic, functional, or reconstructive procedures that provide better outcomes for our family of patients.”

Dr. Shuman, a lecturer who is vice president of Strategic Clinical Relations for Align Technology, expects orthodontics to become a bigger part of many GPs’ practices in the coming years.

“As general practitioners continue to focus on providing the most comprehensive care possible to their patients, and as they strive to grow their knowledge base through continuing education, orthodontics will play a larger and larger role in their practices,” Dr. Shuman said. “Other factors that will drive this are the importance of adult tooth movement in ideally setting up for restorative, as well as the 70% of adults that present with lower anterior crowding.

“These patients are interested in correction for functional, periodontal, and esthetic purposes, but have not moved forward due to their reluctance to wear fixed braces as adults. Clear aligner therapy like Invisalign® is alleviating that concern and motivating patients to go forward with treatment. Much of this will be initiated in the hygiene chair in the general practitioner’s office.”

Services offered

Speaking of clear aligner treatment, which includes Align Technology’s Invisalign (www.invisalign.com), NuBrace’s invisible removable orthodontics (www.nubrace.com),

and Dentsply Raintree Essix’s Hilliard Minor Tooth Movement (MTM) system and cosmetic aligners (www.essixcosmeticaligners.com), the latest survey reports that one-third of our readers provide the service (see “Whatcha doing in your practice?”, page 60).

This figure indicates a hefty 74% increase increase in use over the last four years—our 2003 survey showed 19% of the respondents using “invisible” aligner treatment. Dr. Shuman believes the growing number of successful Invisalign cases, as well as the growing list of dentists certified to provide them, has helped sway many adults to go with the treatment.

“Early on, there was a great deal of healthy skepticism about Invisalign treatment,” he said. “The technology was new, and doctors weren’t sure what to expect as they started their first cases. Now, enough time has passed that more and more doctors are seeing their cases finish successfully and according to their treatment goals.”

This has helped the treatment get accepted in dental schools and in the industry as a whole, according to Dr. Shuman. “Academic and industry recognition has also been a critical factor,” he added.

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