D AILY A T T H E A A O! ORTHO TRIBUNE The World’s Orthodontic Newspaper · U.S. Edition SATURDAY, MAY 4, 2019 — Vol. 10, No. 1 www.dental-tribune.com ORTHODONTIST BURNOUT? MAKING PATIENTS HAPPY Editor in Chief Dennis J. bartakow addresses the very real concern of burnout and what can be done. ” page 4 Study looks at how the doctor-patient relationship can affect patient satisfaction. ” page 6 BEHIND CLOSED EYES breatment system can address the underlying root causes of children’s sleep disordered breathing. ” page 12 Sit down and settle in If there’s one thing you can be sure of when you attend an AAO Annual Session, it’s that the quality of the learning experience will be top- notch, and this year is no exception. On hand this weekend are renowned lecturers addressing traditional topics, such as Class II and Class III treatment, biomechanics, anchorage/TADs and es- thetics. Other lecture series will cover newer and diverse topics, such as 3-D printing/in-house aligners, finishing, sleep apnea, retention/lingual orthodon- tics and impacted canines/missing teeth. Highlights will include the 2019 Sal- zmann, Angle and Mershon lectures as well as one special lecture being held as a memorium. Jacob A. Salzmann Lecture Dr. Hugo De Clerck will present the 2019 Attendees listen to an educational presentation at the Invisalign iTero booth during the 2018 AAO Annual Session, held in Washington, D.C. This year, a wide variety of booths in the exhibit hall will also be offering educational sessions at various times throughout the weekend. Photo/Ortho bribune File Photo ” See SIT, page 4 Director Ron Howard to headline 2019 Excellence in Orthodontics Awards Academy Award-winning filmmak- er Ron Howard, one of his generation’s most popular directors, will serve as the keynote speaker for this year’s Excellence in Orthodontics Awards Ceremony. The luncheon ceremony takes place from noon to 2:15 p.m. Sunday at the JW Marriott. The awards ceremony, in- cluding the keynote address, begins at 2:15 p.m. A ticket is required to attend either portion ($60 with lunch; $15 to at- tend the keynote address only). Howard has created some of Hollywood’s most memora- ble films, from the critically acclaimed dra- mas “A Beauti- ful Mind” and “Apollo 13” to the hit com- edies “Parenthood” and “Splash” and holiday favorite “How the Grinch Stole Christmas.” His work includes “Cinder- ella Man” starring Oscar winner Russell Crowe, for which Howard earned an Os- car for Best Director and which also won awards for Best Picture, Best Screenplay and Best Supporting Actress. Many of Howard’s other films have also received nods from the academy, includ- ing “Backdraft,” “Parenthood” and “Co- coon,” the last of which took home two Oscars. Howard began his career in film as an actor, first appearing in “The Jour- ney” and “The Music Man,” then as Opie on the long-running television se- ries “The Andy Griffith Show.” He later starred in the popular series “Happy Days” and drew favorable reviews for his performances in “American Graf- fiti” and “The Shootist.” (Source: American Association of Orthodontics)
6 R E SE A RCH Ortho Tribune U.S. Edition | May 4, 2019 Treatment satisfaction and the orthodontist-patient relationships Part one of two By Angelica Chaghouri, Herman Ostrow School of Dentistry, University of Southern California Abstract Patient-centric care has been pervasive across health systems in the United States during the last several years (Ep- stein, Lesser and Levinson, 2010). The same approach of putting patients first in dentofacial treatment is no exception. Individualized care is no easy feat and requires a combination of factors: un- derstanding patients’ goals and expecta- tions, treatment planning, utilizing up- to-date instruments and tools and an open and positive relationship between health-care providers (i.e., orthodon- tists) and patients. Researchers and practitioners alike have poured hours into implementing the best treatments and tools to achieve patient success, and less attention has been paid to how orthodontists’ rela- tionships affects patients’ satisfaction with their outcomes. The study sought to understand how doctor-patient relationships influence patient satisfaction with their orth- odontic treatment by soliciting survey questionnaire responses from patients AD Coming up To read part two of this article, please pick up the Ortho Tribune AAO Show Daily Issue 2, available outside the convention center, on Sunday. in three different clinic environments. A majority of patients who were satisfied with treatment and the overall experi- ence also had very positive relationships with their orthodontists. Orthodontist-patient relationships and treatment satisfaction Are orthodontia patients satisfied with their outcomes upon the completion of treatment? The days of the all-knowing doctor are over, and as health-care pro- viders, we cannot be satisfied solely if a patient received and completed a treatment (Anwar, 2017). Doctors need to give attention to the wholeness of a patient’s experience throughout treat- ment, which is commonly referred to as patient-centric care. Before patient-centric care was a pri- ority, doctors solely dictated treatment plans, but that has changed in recent years. Today, doctor-patient relation- ships are a large part of the patient’s overall experience. It is no longer sat- isfactory to simply address a patient’s chief complaint. Patient satisfaction with treatment outcome is a function of the care received. The relationship between orthodon- tists and their patients was studied to determine if the nature of these rela- tionships had an impact on the patient’s feelings about his or her treatment out- come. More than two dozen patients were surveyed about their relationship with their orthodontist. The survey data was not meant to find a causal or correlative relation- ship between patient satisfaction and doctor-patient relationships. Still, this researcher finds meaningful insight can be gleaned from the data to explore the importance of doctor-patient relation- ships for treatment outcomes. This research study was motivated by my personal experience with orthodon- tic care as a young patient. For many young patients, orthodontic treatment can be the first contact an individual has with a health system, and the orthodon- tist could become a standard for all fu- ture doctor visits. The long-term contact with an ortho- dontist may also color an individual’s perceptions of future contact with other health-care providers. impacting patient satisfaction varied. Pacheco-Pereira, Pereira, Dick, Perez and Mir (2015) found that patient satisfaction was associated with at least three differ- ent factors: perceived esthetic outcomes, psychological outcomes and quality of care. According to Bos, Hoogstraten and Prahl-Andersen (2003), a patient’s atti- tude toward his/her appearance before orthodontic treatment would affect the perception of treatment after comple- tion. If a patient has pre-treatment goals, how hopeful can the orthodontist be re- garding improving perceptions by pro- viding care? Pacheco-Pereira et al. sug- gested that “quality of care” could be one of the answers. Pacheco-Pereira et al. defined “quality of care” in terms of dentist-staff-patient interactions during the course of treat- ment. Sinha, Nanda and McNeil (1996) concluded that orthodontist-patient re- lationships had a significant effect on satisfaction, compliance and adherence during treatment. Sinha et al. (1996) surveyed more than 200 adults before and after completing orthodontic treatment that provided evidence linking doctor-patient relation- ships and satisfaction. They suggested that an orthodontist’s behavior was correlated to patient satisfaction. They identified behaviors such as politeness, friendliness, empathy and communica- tiveness as influential in affecting sat- isfaction — the most important were politeness, reassurance and concern. Their research revealed that the doctor’s calm, confident attitude and unhurried approach increased patient satisfaction (Sinha et al., 1996). Sinha et al. emphasized that patient compliance was definitely related to treatment satisfaction. Nanda and Kierl (1992) found that patient-doctor relation- ships have a significant effect on patient compliance and treatment outcome. There was conflicting research on the topic of compliance. In 2003, Bos et al. found that individuals who were gener- ally satisfied with their smile had differ- ent expectations than those whose self- perception of their teeth was bad. In 2005, Bos et al. found that there was not a strong correlation between compli- ance and satisfaction but that sex was a better predictor of satisfaction than com- pliance. This suggested that a function of pa- tient satisfaction with treatment out- come might be based on pre-treatment appearance, which an orthodontist would have no control over. Literature review The literature demonstrated that factors (Editor’s note: References will be includ- ed at the end of part two.)
8 E X H I BI TOR Ortho Tribune U.S. Edition | May 4, 2019 Dolphin moves its cloud to SaaS model with Cloud Subscription By Matt Yamamoto, Director of Sales, Dolphin Dolphin’s reputation is marked by our eagerness to embrace new technologies and use them to develop cutting- edge solutions for our customers. Back in 2012, we were excited to introduce Dolphin Cloud Sessions — joining the call of “cloud computing” and leading orthodontics into the newest trend. In this same spirit, and to better serve the needs and preferences of our cus- tomers, we are now happy to announce a new SaaS (software as a service) model for our cloud product. We are calling it Cloud Subscription, which essentially means that customers can “subscribe” to the software rather than “buy” it. Dolphin Subscription will be offered in two three-tiered packages to accom- modate the different needs and size of a practice. Customers will have the choice of an Imaging and Imaging & Manage- ment package. All updates, backups and support are included in the subscription price, with plans starting at $180 per month. Here are some frequently asked ques- tions about the service. Tell me again what Dolphin Cloud is? Cloud Subscription lets you enjoy full- featured Dolphin Imaging and Man- agement programs in the cloud. It eliminates the need for a local server to handle your Dolphin database, thereby eliminating costly server purchases and the fees associated with configuration and maintenance. We automatically update your soft- ware and perform the necessary, regular data backups. You run the latest version of Dolphin software, every time. And, Cloud Subscription seamlessly supports multiple offices. Sounds cool. How does it do all that? Cloud Subscription utilizes industry- standard technologies such as remote desktop connection, remote apps and virtual workstations. An appropriate combination of these technologies is used to create a virtual server environ- ment to deliver the Dolphin software and data to your practice. Will my data be secure? Cloud Subscription is hosted in an “SSAE-16 Type II certified” hosting facil- ity, which adheres to all the latest securi- ty and network requirements for profes- Illustration/Provided by Dolphin sional hosting of data and applications. The Type II Certification measures and evaluates security over time. OK, OK. What does ‘Cloud computing’ mean anyway? Cloud computing is the practice of using a network of remote servers hosted on the internet to store, manage and pro- cess data, rather than a local server or a personal computer. What are the compatible devices of Dolphin Cloud Subscription? You can connect to Dolphin Cloud Sub- scription using most desktop and mo- bile devices, including: • Windows PCs • Macs • smartphones (iOS and Android) • tablets (such as iPads and even the Microsoft Surface) Finally, Dolphin Cloud Subscription is backed by the same solid team that has spent more than 30 years developing and supporting software solutions for the dental specialty industry. Added stability is provided by Patter- son Dental, the organization that owns Dolphin, and a company with 140-year history serving the dental community. Got more questions? Contact Matt Yamamoto, at left, Director of Sales, Dolphin, at (800) 548-7241 or visit www. dolphinimaging.com/ cloud. Here in Los Angeles To learn even more about the new Dolphin Sub- scription, stop by the booth, No. 1025.
10 E X H I BI TOR S Ortho Tribune U.S. Edition | May 4, 2019 tops teleOrthodontic Platform can put the orthodontic practice in the palm of your patients’ hands By Mark S. Sanchez, DDS, founder, CEO and chief developer at tops Software In it’s landscape, today’s competitive orthodon- tic important to of- fer speed and convenience. The tops teleOrthodontic Platform™ — powered by Rhinogram — brings the ultimate in patient convenience to any orthodontic practice. We have created a way for new and existing patients to almost literally put an orthodontist’s practice in the palm of the patients’ phones. It’s the phones they look at for hours a day — with their social media presence AD tied to directly to topsOrtho. Rhinogram reports that four out of five patients want the ability to text with their orthodontist. Texting is fast, easy and convenient. It gives the patient and the practice their time to choose and en- gage. Patients can tap to send a Facebook Messenger text directly to the inbox in topsOrtho. From there, your staff can respond and answer initial patient ques- tions. In fact, your staff can handle five times as many inquiries via topsOrtho messaging than by incoming patient phone calls. Rhinogram users have seen amazing results, such as: Here in Los Angeles To learn more about topsOrtho’s teleOrthodontic Platform, stop by the booth, No. 1637. • 25 percent increase in new business. • An additional $80,000 of new pa- tient revenue per month. • And phone call reduction of 50 per- cent. With templated responses, practice staff can direct patients to send photos of their teeth that allow you — the prac- titioner — to do a preliminary consult before the patient ever arrives at your office. This is the kind of convenience that patients today demand. The tops teleOrthodontic platform puts a practice on prospective patients’ phones. Whether they’re at home or at work, any time of day, patients can reach you without sitting on hold for 10 min- utes, and those same patients can begin to interact with a practice before they drive by another practice down the road or walk by a storefront in the mall. Now orthodontists can bring their practice to the patient instead of wait- ing for the patient to come to them. TeleOrthodontics is the future for ortho- dontics. It gives patients better control and options for communicating with a practice, and topsOrtho puts that conve- nience at their fingertips.
12 E X H I BI TOR Ortho Tribune U.S. Edition | May 4, 2019 Are you evaluating sleep, breathing and airway issues in your practice? A comprehensive HealthyStart System provides the tools and methods for treatment By Leslie Stevens, HealthyStart How are we treating children who exhibit sleep, breathing or airway issues? In many instances, we look to re- move tonsils and adenoids, tape a child’s mouth, provide myofunctional therapy or possibly even expand the arches. Is this enough? The answer lies in a uniquely multi- dimensional treatment system called the HealthyStart,® which addresses the underlying root causes by expanding the arches, promoting growth and de- velopment, and addressing improper habits while creating proper habits si- multaneously. The HealthyStart system uses a series of oral appliances typically worn at night while sleeping. 501 children showed that nine out of 10 children ex- hibit one or more outward symptoms of sleep disordered breathing (SDB). These outward symptoms can be identified through the HealthyStart questionnaire, where parents indicate their child’s ap- plicable symptoms and provides the degree of prevalence. On average, chil- dren will have four outward symptoms, which can include: Research involving • ADD/ADHD • Headaches • Nightmares • Teeth grinding • Bed wetting • Difficulty in school • Chronic allergies • Restless sleep • Dark circles under eyes • Mouth breathing • Daytime drowsiness • Snoring • Swollen tonsils/adenoids • Delayed growth • Defiance/aggression Some habits are expressed as behav- iors that are either repetitive or patterns Photos/Provided by Ortho-bain that are instigated by sleep. Examples of repetitive habits are thumb sucking, tongue thrust, mouth breathing, etc., which can be addressed with myofunc- tional therapy. Each HealthyStart Habit Corrector design has myofunctional therapy built into each appliance and is activated by a swallow. Here in Los Angeles To learn more about the HealthyStart System, visit the HealthyStart booth, No. 1819, go online to www.thehealthystart.com, email info@thehealthy start.com or call (844) KID-HEALTHY. During sleep, we swallow one time a minute, and during the day, we swallow two times a minute. When a child wears the HealthyStart appliance at night, 500 corrective repetitions occur to cre- ate a proper swallow, eliminate mouth breathing, create nasal breathing and eliminate tongue thrusts. This assures myofunctional therapy occurs with wear and guarantees constant reinforcement, even during sleep when it’s most needed. Other habits instigated by sleep in- clude bruxism, fidgeting, headaches, bed wetting, allergies, asthma, etc., which HealthyStart addresses by influ- encing positive changes in sleep, breath- ing and the airway. The HealthyStart System promotes growth and development by influencing jaw growth in a forward direction while eliminating detrimental malocclusions and deficiencies in jaw development and growth. HealthyStart treats any overbite, overjet, open-bite, crossbite, gummy smile, Class III and deficiencies in both the upper and lower arches. The HealthyStart system will promote 54 percent growth in the mandible as compared to the control sample. The HealthyStart treatment allows maxi- mum airway development. The System expands arches to gain greater nasal breathing and provides an area for the tongue to position in the upper palate. The proprietary HealthyStart tech- nique incorporates built-in myofunc- tional therapy with a ramp to lift tongue and expansion tabs to flatten tongue and add pressure for expansion of the arch- es. Additional expansion is gained with the eruption of teeth. The HealthyStart system utilizes natural eruptive forces of the teeth to gain approximately 4 mm of expansion. Typically the expansion that is gained with use of the Healthy- Start system represents 77 percent of the needed expansion of pediatric patients. Learn more about the HealthyStart technique, which addresses the underly- ing root causes of SDB, creates dramatic changes in occlusions, promotes jaw growth, creates proper habits and elimi- nates poor habits all while expanding the arches. Complimentary educational webinars are available at www.healthy startwebinar.com, and 1 C.E. credit is pro- vided. Make a more permanent change for your sleep patient by treating early and treating for life.
14 PRODUC T S Ortho Tribune U.S. Edition | May 4, 2019 TAGLUS Aligner/Retainer material By Allure Ortho Staff Align announces new iTero updates and connectivity TAGLUS aligner/retainer material has quickly become one of the top choices for clear aligners and retainers, according to Allure Ortho. By Align Staff The company asserts that it is super strong, super clear and super affordable. According to the company, it performs as well as Zendora but is half the price, easier to use in fabrication of aligners and retainers, has better polish ability, no moisture sensitivity and no bubbling. For more information or to place an order, you can call Allure Ortho at (844) 442-5587, email email@example.com or stop by the booth, No. 525. Photo/Provided by Allure Ortho AD Align Technology has announced mul- tiple updates associated with the iTero® Element family of intraoral scanners (iTero Element, Element 2 and Element Flex). 1.7 software upgrade With the 1.7 iTero scanner software up- grade, orthodontists have access to new features that improve scan quality and provide additional functionality for pa- tient data protection. These improved features include: • Improved image quality and resolu- tion of restorative model. • Direct visualization of high- resolution scan in “scan mode.” • Improved scan process for prep seg- ments. • Inactivity logout feature that acti- vates after a pre-defined period of sys- tem inactivity for greater privacy of pa- tient information. In addition, a separate iTero software Here in Los Angeles To learn more about the iTero and how it can help your practice, stop by the booth, No. 2001. Photo/Provided by Align bechnology update also provided customers with an improvement in their experience at myitero.com, with clear visibility to file download status.