6 Month Smiles

[TJNova2011]

I was wondering what the ortho residents/orthodontists think about six month smiles? http://www.6monthsmiles.com/


How successful is this? On dental town, the docs doing this course who are pursuing ortho have been really successful. Does this treat the more tame class I? What's your recommendation for a general dentist who wants to do some ortho?

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[KlingonDentist]

6 month smiles...so easy even a caveman can do it.

 

[orthotobe]

Check out Progressive Orthodontics; it is supposedly the best ortho training available for general dentists. They rave about it on dentaltown.

 

[barbed wire]

It works great with patients who love large overjets, having midlines off, and massive IPR. Not to mention the best part - their teeth doesn't fit together. It's funny with all these positives they never post pictures except - "look the front 6 teeth are straight."

It's a garbage program that won't be around in 3-5 years. IMHO - I think GPs who mess up occlusion doing this and charge a pretty penny to do it are looking at lawsuits.

 

[kato999]

Couldn't agree more. I have yet to see a "6 month ortho" case treated that would pass the American Board of Orthodontics clinical exam.

Just understand you do not have to be a specialist to provide specialty treatment, but you are held to the the standard of care of the specialists.

That being said, I have seen some GP's do quality ortho, it's just not the 6 month braces in a box garbage that they are advertising over on dentaltown.

 

[Turnerjo13]

It is not comprehensive orthodontics. It is more of a "lets get these teeth into a place where we can successfully do crowns and veneers". I have to say that the the process with the lab and the NI-Ti wire is neat.

 

[Istr8nthem]

It is not comprehensive orthodontics. It is more of a "lets get these teeth into a place where we can successfully do crowns and veneers". I have to say that the the process with the lab and the NI-Ti wire is neat.

They are using this for SOME cases, but most are adults who are looking for a quick fix to straighten anterior teeth. Many GP's are also charging comprehensive ortho prices for 6 months or less of treatment that is not even finishing the case. This is unethical in my mind. Also, you say that "the Niti wire is neat" but fail to realize that these 6 month ortho guru's are not even getting into rectangular wire and fully expressing the expensive brackets they are buying. By not torquing the teeth properly, you are setting the case up for failure post-treatment, but they are combating this by using fixed lingual retention bonding to the lingual of every tooth they can. This whole thing is just skeevy if you ask me! Many GPs are doing a fine job, but many others are in it completely for the money, and that is wrong!

 

[6 Month Smiles]

Hi all! My name is Dr. Ryan Swain and I am president and chief clinical instructor for 6 Month Smiles. This thread was driving quite a bit of traffic to our www.6MonthSmiles.com website so I thought I'd check it out. It sounds like there is some misinformation regarding what 6 Month Smiles is all about.

6 Month Smiles is an alternative for adult patients who are unwilling to proceed with Traditional Comprehensive Orthodontics. It is very similar in scope to Invisalign treatment. But as most know, brackets and wires are much more efficient than aligners. The attractive combination of short treatment times and clear brackets is very attractive to adult patients. So, when they are unwilling to proceed with traditional orthodontics, we can provide them with a more limited and reasonable alternative. It's a much more conservative option than prepping teeth on patients who won't do traditional orthodontics.

For more info and case results, please visit the dentist section at our site- www.6MonthSmiles.com.

Thanks,

Dr. Ryan Swain

 

[6 Month Smiles]

Couldn't agree more. I have yet to see a "6 month ortho" case treated that would pass the American Board of Orthodontics clinical exam.

Just to add to the discussion, the goal of Short Term Ortho is NOT to provide a "board certified" finish. The goal is to focus on correcting the patient's chief cosmetic complaint and greatly improve the overall symmetry and beauty of the smile. Short Term Ortho is an orthodontic alternative for the many adults who aren't interested in wearing braces for as long as it takes to get a "board certified" result.

Take care,

Ryan

 

[gryffindor]

There is nothing magical or neat about NiTi that is unique to 6 months of anything. You can get into a rectangular NiTi within 3 months if you wanted to. But maybe that's why I went through a 3 year residency to gain that little clinical pearl.

 

[KlingonDentist]

It is a compromised treatment and the pts are explicitly told.

It is explicitly stated to the pts that its goals are limited and straightening the front is is its main goal and nothing else.

It is a more conservative treatment than crowns and veneers on virgin teeth for cosmetic reasons. (This reason alone is very attractive to GPs and Pts alike)

It is alot cheaper than 6-8 crowns/veneers Max and Mand.

Having said that, there are cases that are pushing the boundaries with 6 mth smiles. Not good occl and over jet being a couple. NO ant or canine guidance ( but many can live without them anyways)

Having done these myself as a GP Some results are phenomenal but many are also compromised (at least in my mind) pts are happy but I'm not too happy due to torque or other minor issues.

I decided to go back to ortho school and will do so next yr.
I need to sleep good at night.
others may not need good sleep othersie they don't think of such issues as important. It is to me.

 

[Cold Front]

Hi all! My name is Dr. Ryan Swain and I am president and chief clinical instructor for 6 Month Smiles. This thread was driving quite a bit of traffic to our www.6MonthSmiles.com website so I thought I'd check it out. It sounds like there is some misinformation regarding what 6 Month Smiles is all about.

6 Month Smiles is an alternative for adult patients who are unwilling to proceed with Traditional Comprehensive Orthodontics. It is very similar in scope to Invisalign treatment. But as most know, brackets and wires are much more efficient than aligners. The attractive combination of short treatment times and clear brackets is very attractive to adult patients. So, when they are unwilling to proceed with traditional orthodontics, we can provide them with a more limited and reasonable alternative. It's a much more conservative option than prepping teeth on patients who won't do traditional orthodontics.

For more info and case results, please visit the dentist section at our site- www.6MonthSmiles.com.

Thanks,

Dr. Ryan Swain

Dr. Ryan,

How long are your courses? and do you offer student rates for the classes?

btw - I have seen some of your before and after cases on dentaltown, they look great.

 

[Istr8nthem]

Hi all! My name is Dr. Ryan Swain and I am president and chief clinical instructor for 6 Month Smiles. This thread was driving quite a bit of traffic to our www.6MonthSmiles.com website so I thought I'd check it out. It sounds like there is some misinformation regarding what 6 Month Smiles is all about.

6 Month Smiles is an alternative for adult patients who are unwilling to proceed with Traditional Comprehensive Orthodontics. It is very similar in scope to Invisalign treatment. But as most know, brackets and wires are much more efficient than aligners. The attractive combination of short treatment times and clear brackets is very attractive to adult patients. So, when they are unwilling to proceed with traditional orthodontics, we can provide them with a more limited and reasonable alternative. It's a much more conservative option than prepping teeth on patients who won't do traditional orthodontics.

For more info and case results, please visit the dentist section at our site- www.6MonthSmiles.com.

Thanks,

Dr. Ryan Swain

You may want to fork over a few bucks to SDN for the free advertisement!! In all seriousness, I see the point of short term ortho for a very select patient base, but the way it's being marketed (not saying you are condoning it) within the general dentist community, it is giving quite a few people (patients and doctors) the wrong idea. For GP's to be doing short term ortho with very little/no training on diagnosis and case selection is a bit dangerous. People simply don't know what they don't know when it comes to ortho. I am not saying that GP's shouldn't do ortho, I am saying that they need to have the appropriate training on diagnosis and case selection. It took me 2 full years (plus some) to fully understand how important correct diagnosis is and I still make mistakes that come back to bite me.

No matter what kind of ortho you are doing, it still requires adequate record taking, diagnosis and treatment planning along with a damn good informed consent to cover yourself. You must explain that this is not solving all the problems and that there are better overall options for occlusion and prevention of TMD and other issues that can arise from malocclusions. That's all.

 

[HupHolland]

You may want to fork over a few bucks to SDN for the free advertisement!! In all seriousness, I see the point of short term ortho for a very select patient base, but the way it's being marketed (not saying you are condoning it) within the general dentist community, it is giving quite a few people (patients and doctors) the wrong idea. For GP's to be doing short term ortho with very little/no training on diagnosis and case selection is a bit dangerous. People simply don't know what they don't know when it comes to ortho. I am not saying that GP's shouldn't do ortho, I am saying that they need to have the appropriate training on diagnosis and case selection. It took me 2 full years (plus some) to fully understand how important correct diagnosis is and I still make mistakes that come back to bite me.

No matter what kind of ortho you are doing, it still requires adequate record taking, diagnosis and treatment planning along with a damn good informed consent to cover yourself. You must explain that this is not solving all the problems and that there are better overall options for occlusion and prevention of TMD and other issues that can arise from malocclusions. That's all.

I don't think Dr Swain is advertising, but rather defending some of the posts that are slamming his program.

On the other, I was watching some of the videos on his website and one of the models said, word for word, "let me introduce you to the most effective solution for crooked teeth, 6 month smiles!" I would hardly call short term ortho the most effective solution. It is, however, a viable solution for some if they understand that there are other options out there and are informed of the risks and benefits of each.

Hup

 

[barbed wire]

Great. The 6 month guy has taken over this thread with a few of his clones. Go get 'em guy - just like you do on dental town. Turn this into another plug for a flawed system.

Shameless.

 

[bsmcga0]

sorry, I should have let this die,
but the cases on the website are pretty bad, and I have to imagine these are the best ones

Case 1: finished with deep bite, tip on 10 looks off, looks like crossbite on left, midline off
Case 2: to much overjet, crossbite on left, end on right side, open bite posterior,
Case 3: CL II canine, midlines are off, 23 is severely tipped

occlusion is off in all, I am sure looks worse from the lateral

in my opinion, these don't look like cases that just needed to be aligned for veneer preps

 

[monreal]

sorry, I should have let this die,
but the cases on the website are pretty bad, and I have to imagine these are the best ones

Case 1: finished with deep bite, tip on 10 looks off, looks like crossbite on left, midline off
Case 2: to much overjet, crossbite on left, end on right side, open bite posterior,
Case 3: CL II canine, midlines are off, 23 is severely tipped

occlusion is off in all, I am sure looks worse from the lateral

in my opinion, these don't look like cases that just needed to be aligned for veneer preps

Don't be mean! In his defense, they look the same before and after the treatment. At least, "Do no harm" was not fully violated.

 

[berserker]

So...."They look the same before and after treatment"...What then was the Tx for? To lighten the heavy burden of their wallets? How is that "Do No Harm" ??? Is it ok to offer subpar treatment at the cost of comprehensive treatment? Why not offer "One Month Smiles"? It still looks the same, right? Not really...some of those cases have increased overjet, occlusion off and root angulation issues. But of course, this is hard to see if full records are not posted. A part of dental education is professional ethics, " Do the right thing and then do the thing right".
This concept is great for propagating poor, potentially unethical and sub-standard treatment. It must be a luxury to have the abyssmal standards that you endorse. Other than very few select cases, this option is just to rip-off ill-informed consumers. If that is the kind of dentistry you want to do...well, that bespeaks volumes about your standards.

 

[monreal]

You missed the sarcasm. Welcome to the forum berserker.

 

[berserker]

Sorry...missed that one

 

[KlingonDentist]

I'm not defending 6 mth smiles but I want to point out also a fact that some orthodontist are also finishing cases with overjet and no anterior/canine guidance. I saw this with my own eyes through my private practice.
As orthodontists (or future ortho) we need to raise the bar and not be sloppy.
I understand that there are many orthodontists who are not qualified or don't deserve to be one and I certainly know a few.

But don't let these black sheeps become the norm in ortho world as many circles of GP are indeed mocking orthodontists as overrated. And they are mocking us indeed, I know this as I am still a GP (will be an ortho soon) and have been around long enough to know what they are saying behind our backs.

Orthodontists are a laughing stock in many GP circles and this is sad.

 

[Ligature]

I'm not defending 6 mth smiles but I want to point out also a fact that some orthodontist are also finishing cases with overjet and no anterior/canine guidance. I saw this with my own eyes through my private practice.
As orthodontists (or future ortho) we need to raise the bar and not be sloppy.
I understand that there are many orthodontists who are not qualified or don't deserve to be one and I certainly know a few.

But don't let these black sheeps become the norm in ortho world as many circles of GP are indeed mocking orthodontists as overrated. And they are mocking us indeed, I know this as I am still a GP (will be an ortho soon) and have been around long enough to know what they are saying behind our backs.

Orthodontists are a laughing stock in many GP circles and this is sad.

Klingon,
Sometimes it is not POSSIBLE to eliminate all excess overjet for a multitude of reasons. It is difficult to judge why a case finished the way it did without knowing alot about ortho. But if you are charging full treatment fees, then you should be doing full treatment methinks

 

[HupHolland]

Klingon,
Sometimes it is not POSSIBLE to eliminate all excess overjet for a multitude of reasons. It is difficult to judge why a case finished the way it did without knowing alot aut ortho. But if you are charging full treatment fees, then you should be doing full treatment methinks

What is considered "full treatment fees"?? As a dentist--doesn't matter if you're a GP or an orthodontist--you can charge WHATEVER you want. However, with that said, it is your responsibility to let your patients know when the treatment you are providing is a compromised treatment.

Most adults are not willing to wear braces for years. Many adults will need surgery for a result that would pass an AAO board exam. I don't see anything wrong with 6 month smiles as long as the dentists providing the service aren't representing themselves as specialists and if they are obtaining a properly informed consent.

Hup

 

[Cold Front]

What is considered "full treatment fees"?? As a dentist--doesn't matter if you're a GP or an orthodontist--you can charge WHATEVER you want. However, with that said, it is your responsibility to let your patients know when the treatment you are providing is a compromised treatment.

Most adults are not willing to wear braces for years. Many adults will need surgery for a result that would pass an AAO board exam. I don't see anything wrong with 6 month smiles as long as the dentists providing the service aren't representing themselves as specialists and if they are obtaining a properly informed consent.

Hup

Legally, that's setting yourself up for malpractice. If you are a competent GP and know what you are doing, then why would you even bring this up? Just let the patient know you are not a specialist, no need to discuss the level of care - it's expected to be as good as an orthodontist (or very close to).

I am sure most doctors are not willing to accept a case they can't handle, so this shouldn't even be an issue, unless you are totally risking everything (license, reputation, practice, and career).

 

[HupHolland]

Legally, that's setting yourself up for malpractice. If you are a competent GP and know what you are doing, then why would you even bring this up? Just let the patient know you are not a specialist, no need to discuss the level of care - it's expected to be as good as an orthodontist (or very close to).

I am sure most doctors are not willing to accept a case they can't handle, so this shouldn't even be an issue, unless you are totally risking everything (license, reputation, practice, and career).

Dentists deliver "compromised treatment" all the time. I don't see how this is any different than a patient requesting a bridge when you recommend an implant. The patient doesn't want the implant because it's a surgical procedure and it will take them longer to get their tooth. How is this any different than an adult patient not wanting ideal ortho as often times it requires surgery and years of braces.

But you're right though. You need to make it clear to the patient that you're not an orthodontist. Explain that and orthodontist goes through years of additional schooling to straighten teeth, and that can do it better than you, the GP.

Hup

 

[barbed wire]

Dentists deliver "compromised treatment" all the time. I don't see how this is any different than a patient requesting a bridge when you recommend an implant. The patient doesn't want the implant because it's a surgical procedure and it will take them longer to get their tooth. How is this any different than an adult patient not wanting ideal ortho as often times it requires surgery and years of braces.

But you're right though. You need to make it clear to the patient that you're not an orthodontist. Explain that and orthodontist goes through years of additional schooling to straighten teeth, and that can do it better than you, the GP.

Hup

This is what drives me crazy about this system (and some GPs who do poor ortho). Let's all think about delivering a bridge. How much work goes into making sure contacts are correct, the bridge is not in high occlusion, working and non-working interferences are adjusted/eliminated, proper canine guidance, etc. Seating a bridge demands a significant amount of time and detail. Yet some of these same GPs think this all goes out the window when orthodontics is involved

Compare seating a bridge to 6 months of braces. The teeth are mostly "derotated" and look good and granted in a very few cases there might be decent occlusion. But in most of my cases the bite is off. CR/CO is worse off, a lot teeth have cusp - cusp contact only, arch dimensions are not coordinated, anterior open bites develop if vertical is not controlled, etc. The next 12 months is spent trying to finish - which is correcting all things you messed up in the first 6 months. In my opinion, orthodontics is all about finishing to prostodontic/occlusion guidelines that you demand of yourself when seating a bridge.

Talk about opening your self to litigation. Think about this scenario.

45-yo female does the 6 month braces. She is happy with her "look" but her bite doesn't fit together and now has a significant lateral and anterior CR to CO shift with difficulty chewing, non-working interferences, etc. 2 years later she develops TMD. She sees a TMj specialist, who determines that most of her problems started after 6 month smiles. HELLO Lawyers. The lawyers would ask for start and finish records (models and xrays) of the orthodontic treatment. No malpractice company would defend you and the company would beg for an out of court settlement. How easy would it be for a jury to see what an good orthodontic finish is and how poor 6 month smiles is.

By definition this 6 month smiles IS below the standard of care, not just a compromise.

 

[QCkid]

This is what drives me crazy about this system (and some GPs who do poor ortho). Let's all think about delivering a bridge. How much work goes into making sure contacts are correct, the bridge is not in high occlusion, working and non-working interferences are adjusted/eliminated, proper canine guidance, etc. Seating a bridge demands a significant amount of time and detail. Yet some of these same GPs think this all goes out the window when orthodontics is involved

Compare seating a bridge to 6 months of braces. The teeth are mostly "derotated" and look good and granted in a very few cases there might be decent occlusion. But in most of my cases the bite is off. CR/CO is worse off, a lot teeth have cusp - cusp contact only, arch dimensions are not coordinated, anterior open bites develop if vertical is not controlled, etc. The next 12 months is spent trying to finish - which is correcting all things you messed up in the first 6 months. In my opinion, orthodontics is all about finishing to prostodontic/occlusion guidelines that you demand of yourself when seating a bridge.

Talk about opening your self to litigation. Think about this scenario.

45-yo female does the 6 month braces. She is happy with her "look" but her bite doesn't fit together and now has a significant lateral and anterior CR to CO shift with difficulty chewing, non-working interferences, etc. 2 years later she develops TMD. She sees a TMj specialist, who determines that most of her problems started after 6 month smiles. HELLO Lawyers. The lawyers would ask for start and finish records (models and xrays) of the orthodontic treatment. No malpractice company would defend you and the company would beg for an out of court settlement. How easy would it be for a jury to see what an good orthodontic finish is and how poor 6 month smiles is.

By definition this 6 month smiles IS below the standard of care, not just a compromise.

These are similar to some of the things I have been thinking. I suspect that 5 - 10 years from now, the law suits will put 6 month braces out of business. Unfortunately though, the problem isn't just this one program, its the greedy intentions of the people advocating it. 6 month smiles will eventually go under or transform into something else, but it will be replaced by some other greedy Dr.'s scheme to make money. These people are usually short on morals and ethics and long on their own self interest.

 

[studentdent]

I'm not sure of my opinion on this. If this is used on select cases is it really a compromise of anything? What I am asking is will it cause problems that did not already exist on posterior teeth and occlusion?

If this is not creating problems, then isn't it ok because they are marketed as cosmetic braces. The patient wants better esthetics so they will pay for it and that is what they will get.

Even if it is compromising the ideals, isn't that already something that is done and accepted in dental cosmetics. If patients with severe crowding and misaligned teeth want to have a more esthetic smile, won’t they pay a dentist a lot of money to cut away what might be healthy tooth structure to put on veneers to achieve that appearance? And in creation of prosthetics such as crowns and bridges isn't the structure/strength compromised by layering multiple materials in order to achieve a better look rather than making it monolithic.

Compromise is something we have to deal with, but we have to be able to judge if this compromise is only taking away from the ideal or if it is actually harming the patient.

 

[Demeter]

It works great with patients who love large overjets, having midlines off, and massive IPR. Not to mention the best part - their teeth doesn't fit together. It's funny with all these positives they never post pictures except - "look the front 6 teeth are straight."

It's a garbage program that won't be around in 3-5 years. IMHO - I think GPs who mess up occlusion doing this and charge a pretty penny to do it are looking at lawsuits.

There are few lawsuits in dentistry. These usually result from deaths in pediatric sedations, wrong teeth being extracted or patients developing post op parasthesia. I have never heard of a lawsuit because a dentist was unable to achieve an Angle Class I molar relationship.

 

[orthotobe]

Why bother with six month braces and possible litigation when this opportunity presents itself: Revolutionary Orthodontics

 

[HupHolland]

I'm not sure of my opinion on this. If this is used on select cases is it really a compromise of anything? What I am asking is will it cause problems that did not already exist on posterior teeth and occlusion?

If this is not creating problems, then isn't it ok because they are marketed as cosmetic braces. The patient wants better esthetics so they will pay for it and that is what they will get.

Even if it is compromising the ideals, isn't that already something that is done and accepted in dental cosmetics. If patients with severe crowding and misaligned teeth want to have a more esthetic smile, won’t they pay a dentist a lot of money to cut away what might be healthy tooth structure to put on veneers to achieve that appearance? And in creation of prosthetics such as crowns and bridges isn't the structure/strength compromised by layering multiple materials in order to achieve a better look rather than making it monolithic.

Compromise is something we have to deal with, but we have to be able to judge if this compromise is only taking away from the ideal or if it is actually harming the patient.

 

[Jyaki]

There are few lawsuits in dentistry. These usually result from deaths in pediatric sedations, wrong teeth being extracted or patients developing post op parasthesia. I have never heard of a lawsuit because a dentist was unable to achieve an Angle Class I molar relationship.

Funny you mentioned this. There was a GP on dentaltown that extracted the wrong tooth trying to do 6 month smiles.

 

[Jyaki]

I'm not sure of my opinion on this. If this is used on select cases is it really a compromise of anything? What I am asking is will it cause problems that did not already exist on posterior teeth and occlusion?

If this is not creating problems, then isn't it ok because they are marketed as cosmetic braces. The patient wants better esthetics so they will pay for it and that is what they will get.

Even if it is compromising the ideals, isn't that already something that is done and accepted in dental cosmetics. If patients with severe crowding and misaligned teeth want to have a more esthetic smile, won’t they pay a dentist a lot of money to cut away what might be healthy tooth structure to put on veneers to achieve that appearance? And in creation of prosthetics such as crowns and bridges isn't the structure/strength compromised by layering multiple materials in order to achieve a better look rather than making it monolithic.

Compromise is something we have to deal with, but we have to be able to judge if this compromise is only taking away from the ideal or if it is actually harming the patient.

The problem is that not all compromises are the same. Compromises may be warranted in certain situations but are definitely not necessary in all cases. It is not possible to discuss compromises in general terms since they differ with every case and it is the responsibility of the trained practitioner to determine what and when it is acceptable. Just because compromises are occasionally neccessary, it shouldn't be the goal of every treatment.

 

[Extract4u]

I'm not defending 6 mth smiles but I want to point out also a fact that some orthodontist are also finishing cases with overjet and no anterior/canine guidance. I saw this with my own eyes through my private practice.
As orthodontists (or future ortho) we need to raise the bar and not be sloppy.
I understand that there are many orthodontists who are not qualified or don't deserve to be one and I certainly know a few.

But don't let these black sheeps become the norm in ortho world as many circles of GP are indeed mocking orthodontists as overrated. And they are mocking us indeed, I know this as I am still a GP (will be an ortho soon) and have been around long enough to know what they are saying behind our backs.

Orthodontists are a laughing stock in many GP circles and this is sad.

I must say, there is an awful lot of propaganda that goes on in dentistry today. Much of it has to do with clever marketing schemes to sell products or attempts to gain the trust of the unknowing public and the misinformed dentist to sell these products.

Certainly 6-month smiles falls in line with this era of Las Vegas style dentistry that constitutes selling whatever dentistry you can to the benefit of your pocket book. As long as your patient is happy and your making bank, who cares how quickly your work relapses.......plus GP's can sell your company's product.... Dr. Ryan. Woot!

Providing minimally invasive treatment for a more esthestic smile is wonderful and I recommend braces over veneers whenever the situation permits. But when did it become okay to knowingly provide a compromised treatment from the get go??? This is ludicrous. Diagnosis is critical in orthodontics and without adequate training I would venture to say that this is lacking with most 6-month smile providers. A weekend course will not get you there, sorry guys. Please do not be fooled new grads. I know school loans are serious, but watch out. The corporate world is waiting to take advantage of your situation

Mis-information is rampant these days, and this is why i quoted you Klingon. OJ beyond the ideal is sometimes unavoidable and canine guidance is not absolutely necessary for a finished case. Is canine guidance the one size fits all occlusal scheme? I would say no. I would encourage anyone interested in an evidenced based approach to read the following article:

A contemporary and evidence-based view of canine protected occlusion
Donald J. Rinchuse, Sanjivan Kandasamy, and James Sciotec AJODO 2007

Anyway, 6 month smiles is a joke. Good luck turning people into gophers! Just flare em out there and be done. No big deal the social 6 are straight

 

[ortho lurker]

Just wondering... what do GPs do about broken brackets with this system? I understand that the initial strap-up is set by a lab tech utilizing indirect bonding, but what happens mid-way through tx and a bracket is loose? Do you take another impression and send it back to the lab for a "re-boot" like Invisalign? GPs, you can probably get a cheaper lab bill by having your friendly orthodontist set the brackets or mark on the model for you, just make sure to send the harder stuff away.

 

[CanuckDDS]

I must say, there is an awful lot of propaganda that goes on in dentistry today. Much of it has to do with clever marketing schemes to sell products or attempts to gain the trust of the unknowing public and the misinformed dentist to sell these products.

Certainly 6-month smiles falls in line with this era of Las Vegas style dentistry that constitutes selling whatever dentistry you can to the benefit of your pocket book. As long as your patient is happy and your making bank, who cares how quickly your work relapses.......plus GP's can sell your company's product.... Dr. Ryan. Woot!

Providing minimally invasive treatment for a more esthestic smile is wonderful and I recommend braces over veneers whenever the situation permits. But when did it become okay to knowingly provide a compromised treatment from the get go??? This is ludicrous. Diagnosis is critical in orthodontics and without adequate training I would venture to say that this is lacking with most 6-month smile providers. A weekend course will not get you there, sorry guys. Please do not be fooled new grads. I know school loans are serious, but watch out. The corporate world is waiting to take advantage of your situation

Mis-information is rampant these days, and this is why i quoted you Klingon. OJ beyond the ideal is sometimes unavoidable and canine guidance is not absolutely necessary for a finished case. Is canine guidance the one size fits all occlusal scheme? I would say no. I would encourage anyone interested in an evidenced based approach to read the following article:

A contemporary and evidence-based view of canine protected occlusion
Donald J. Rinchuse, Sanjivan Kandasamy, and James Sciotec AJODO 2007

Anyway, 6 month smiles is a joke. Good luck turning people into gophers! Just flare em out there and be done. No big deal the social 6 are straight

Well said.

 

[monreal]

I must say, there is an awful lot of propaganda that goes on in dentistry today. Much of it has to do with clever marketing schemes to sell products or attempts to gain the trust of the unknowing public and the misinformed dentist to sell these products.

Certainly 6-month smiles falls in line with this era of Las Vegas style dentistry that constitutes selling whatever dentistry you can to the benefit of your pocket book. As long as your patient is happy and your making bank, who cares how quickly your work relapses.......plus GP's can sell your company's product.... Dr. Ryan. Woot!

Providing minimally invasive treatment for a more esthestic smile is wonderful and I recommend braces over veneers whenever the situation permits. But when did it become okay to knowingly provide a compromised treatment from the get go??? This is ludicrous. Diagnosis is critical in orthodontics and without adequate training I would venture to say that this is lacking with most 6-month smile providers. A weekend course will not get you there, sorry guys. Please do not be fooled new grads. I know school loans are serious, but watch out. The corporate world is waiting to take advantage of your situation

Mis-information is rampant these days, and this is why i quoted you Klingon. OJ beyond the ideal is sometimes unavoidable and canine guidance is not absolutely necessary for a finished case. Is canine guidance the one size fits all occlusal scheme? I would say no. I would encourage anyone interested in an evidenced based approach to read the following article:

A contemporary and evidence-based view of canine protected occlusion
Donald J. Rinchuse, Sanjivan Kandasamy, and James Sciotec AJODO 2007

Anyway, 6 month smiles is a joke. Good luck turning people into gophers! Just flare em out there and be done. No big deal the social 6 are straight

Nice first post. Two word for you:
- Diagnosis is not rocket science as you folks want everybody to think.
- 6 months braces and short term ortho (I do not do either), such as any other thing in dentistry, work as long as you know their limitations.

One word for everybody else: It surprises me (not really!) how I always get support from endodontists, surgerons, and prosthodontists helping me tackle easier cases, but also explaining to me the difficulties in the cases I should refer to them. However, I am yet to find an orthodontist who say a word more than: "well... send'm over and I'll see what I can do". Go figure.

 

[charlestweed]

One word for everybody else: It surprises me (not really!) how I always get support from endodontists, surgerons, and prosthodontists helping me tackle easier cases, but also explaining to me the difficulties in the cases I should refer to them. However, I am yet to find an orthodontist who say a word more than: "well... send'm over and I'll see what I can do". Go figure.

If you owned a restaurant, would you be willing to reveal your recipe to others? Even if this recipe is a simple one? An extra $200k for an ortho residency is a risky investment and it is definitely not cheap. It is also impossible to teach ortho in just a couple of meetings. It takes time to teach ortho because ortho tx is a long process (usually18-24 months).

 

[monreal]

If you owned a restaurant, would you be willing to reveal your recipe to others? Even if this recipe is a simple one? An extra $200k for an ortho residency is a risky investment and it is definitely not cheap. It is also impossible to teach ortho in just a couple of meetings. It takes time to teach ortho because ortho tx is a long process (usually18-24 months).

Charles we both know the answer to your question, and we both know that surgeons, endo, and prostho took the same risk you guys did, but they still share the love. And you know better than I do that ortho is easy. Now, one weekend is absolutely not enough but all good GP ortho courses are more than just a couple of meetings.

I said I wasn't surprised from orthos not "sharing their recipes" because the reason is obvious: orthos can see 200 patients a day, start 20 case the same day, and still have time to spend with family, unlike other dental specialists who only have one pair of hands. But here there is a problem; orthos are mostly seen as greedy non-sharing folks and want the GP to refer to them ALL the cases. Now here is a question I asked many times and yet to get a good answer for: for all of you ortho people who practiced general dentistry prior to ortho training, did you refer ALL the root canals, kids, bridges, dentures, exos? If YES then where did you borrow the applications fees from?

I am not defending 6MS or STO here, I actually believe that they are borderline malpractice at best. I am just sick of most ortho folks claiming that no GP can do what they are doing. And I am not referring to you, since I admire your contribution to the forum and your honesty when you write in your posts that ortho is so easy.

 

[servitup]

If you owned a restaurant, would you be willing to reveal your recipe to others? Even if this recipe is a simple one? An extra $200k for an ortho residency is a risky investment and it is definitely not cheap. It is also impossible to teach ortho in just a couple of meetings. It takes time to teach ortho because ortho tx is a long process (usually18-24 months).

Oral surgeons happily teach dental students how to take out teeth but orthodontists would never reveal just how easy it is for 75% of their cases.

 

[og2]

Oral surgeons happily teach dental students how to take out teeth but orthodontists would never reveal just how easy it is for 75% of their cases.

i actually agree that it would be nice to teach/help GP's treat ortho cases; however, i think ctweed makes an interesting point -- tx of endo/prosth/oms/etc all are a little bit different than orthodontic tx bc of the length of time involved. it's probably not quite so easy for an orthodontist to walk a GP through a 1-1.5 year case...it would require quite a commitment. on the other hand, endo/prosth/oms/etc can easily teach/help a GP complete a RCT/extraction/whateverelse within a matter of minutes to hours..

just something to think about..

 

[charlestweed]

Charles we both know the answer to your question, and we both know that surgeons, endo, and prostho took the same risk you guys did, but they still share the love. And you know better than I do that ortho is easy. Now, one weekend is absolutely not enough but all good GP ortho courses are more than just a couple of meetings.

Not just the greedy orthos. Every specialist wants the GPs to refer as many cases (even the simple ones) to his/her office as possible….a specialist who denies this is either a big liar or a specialist who doesn't want to have a successful business. You actually put the specialists in an awkward position when you ask them to teach you how to perform RCT, raise a flap, take out 3rd molars etc. They don't really want to show you but they can't say no since they desperately need your referral.

I said I wasn't surprised from orthos not "sharing their recipes" because the reason is obvious: orthos can see 200 patients a day, start 20 case the same day, and still have time to spend with family, unlike other dental specialists who only have one pair of hands. But here there is a problem; orthos are mostly seen as greedy non-sharing folks and want the GP to refer to them ALL the cases. Now here is a question I asked many times and yet to get a good answer for: for all of you ortho people who practiced general dentistry prior to ortho training, did you refer ALL the root canals, kids, bridges, dentures, exos? If YES then where did you borrow the applications fees from?

I know many dentists and specialists don't like us because we get compensated very well for doing very little…and as you mentioned before, ortho diagnosis is not rocket science. You need to understand that to have such good life style, we had to sacrifice a lot. We often get ridiculed by our classmates for working so hard in dental school (well, I didn't have to go through this since I went to a non-competitive P/F dental school). We spent 2-3 extra years and borrowed $50-200k for the ortho residency. Despite the warnings from many practicing orthodontists (such as Dort-Ort, QCkid, Firm etc) that ortho is a dying specialty, many dental students and practicing dentists still try apply to as many ortho programs as possible to increase their chance of acceptance….This is a huge risk, don't you think?

Monreal, I know you also had to sacrifice a lot to get to where you are today. How do you feel when people think you are greedy dentist?...just because you spend less than 30 minutes to restore an implant and get paid $1000. Would you show a rookie dentist how to restore implants when you know his practice is just a few block away from yours?

I am not defending 6MS or STO here, I actually believe that they are borderline malpractice at best. I am just sick of most ortho folks claiming that no GP can do what they are doing. And I am not referring to you, since I admire your contribution to the forum and your honesty when you write in your posts that ortho is so easy.

As a GP, you can legally do ortho and who care what the orthos think. If you really want to learn ortho, read the Proffitt's textbook instead of asking my ortho colleagues for help. The book is much more helpful and a lot cheaper than the weekend ortho courses for GPs.

 

[charlestweed]

Oral surgeons happily teach dental students how to take out teeth but orthodontists would never reveal just how easy it is for 75% of their cases.

I used to think like you when I was still in the residency. Trust me, when you have your own private practice and you have to pay back your student loans, office rents, business loans etc, you will think differently.

 

[CanuckDDS]

Not just the greedy orthos. Every specialist wants the GPs to refer as many cases (even the simple ones) to his/her office as possible….a specialist who denies this is either a big liar or a specialist who doesn’t want to have a successful business. You actually put the specialists in an awkward position when you ask them to teach you how to perform RCT, raise a flap, take out 3rd molars etc. They don’t really want to show you but they can’t say no since they want your referral.

I know many dentists and specialists don’t like us because we get compensated very well for doing very little…and as you mentioned before, ortho diagnosis is not rocket science. You need to understand that to have such good life style, we had to sacrifice a lot. We often get ridiculed by our classmates for working so hard in dental school (well, I didn’t have to go through this since I went to a non-competitive P/F dental school). We spent 2-3 extra years and borrowed $50-200k for the ortho residency. Despite the warnings from many practicing orthodontists (such as Dort-Ort, QCkid, Firm etc) that ortho is a dying specialty, many dental students and practicing dentists still try apply to as many ortho programs as possible in increase their chance of acceptance….This is a huge risk, don’t you think?

Monreal, I know you also had to sacrifice a lot to get to where you are today. How do you feel when people think you are greedy dentist?...just because you spend less than 30 minutes to restore an implant and get paid $1000. Would you show a rookie dentist how to restore implants when you know his practice is just a few block away from yours?

As a GP, you can legally do ortho and who care what the orthos think. If you really want to learn ortho, read the Proffitt’s textbook instead of asking my ortho colleagues for help. The book is much more helpful and a lot cheaper than the weekend ortho courses for GPs.

Thank you for the post. Somebody needed to put that in writing. I find it funny that it seems like ortho's are the one's being called greedy! Last time I checked it wasn't easy getting into ortho? Nor was it cheap? I guess someone gave you that education for nothing...

I think "deserving" is a better adjective than "greedy".

How many GP's will actually pick up Proffitt and read it Charles? The answer is none- that takes effort and you don't get paid for it.


Pay some Ortho 100k (like they paid in tuition) plus 400+k ($ lost for the extra 2-3 years school) and I'm sure they will gladly teach you GP's ortho.

Sheesh- when I hear this crap it makes me cringe. Calling ortho's greedy and then poaching easy cases and letting them do the hard work (treatment planning a case where a kid's face can get F*$ked up is actually hard work) makes you sound GREEDY dude.

I think they should let hygienists start their own practices and place fillings/single unit crowns. Buccal pit composites are not rocket science....

 

[monreal]

i actually agree that it would be nice to teach/help GP's treat ortho cases; however, i think ctweed makes an interesting point -- tx of endo/prosth/oms/etc all are a little bit different than orthodontic tx bc of the length of time involved. it's probably not quite so easy for an orthodontist to walk a GP through a 1-1.5 year case...it would require quite a commitment. on the other hand, endo/prosth/oms/etc can easily teach/help a GP complete a RCT/extraction/whateverelse within a matter of minutes to hours..

just something to think about..

Interesting point but I think it's the exact opposite. When I am taking out a tooth I need to make decisions in seconds, or minutes. But in ortho, I have a frigging two years. Well not really but you got the point. You make a dumb thing today and dismiss the patient knowing that you can take that wire off anytime. I am not saying to experiment on patients but you can always fix your mistakes in ortho without causing damage to the patient.

A GP who wants his orthodontist to "walk him through" anything should never do ortho. It's not like that, I do not expect any specialist to come and train me. But I expect my surgeon to answer my question: "Hey I got a guy taking Bisphosphonate XX mg, whats the protocol these days?" or my endo to bail me out when I break a file without badmouthing me in front of my patient.

 

[monreal]

Not just the greedy orthos. Every specialist wants the GPs to refer as many cases (even the simple ones) to his/her office as possible….a specialist who denies this is either a big liar or a specialist who doesn’t want to have a successful business. You actually put the specialists in an awkward position when you ask them to teach you how to perform RCT, raise a flap, take out 3rd molars etc. They don’t really want to show you but they can’t say no since they desperately need your referral.

Of course they need GP's referral, and they do get many, but they also do not expect the GP to do filling all day long and refer everything out. Again I do not expect anyone to "teach me" how to raise a flap but if I lost a tooth in the sinus I expect the OS to see my patient and deal with this "accident"

I know many dentists and specialists don’t like us because we get compensated very well for doing very little…and as you mentioned before, ortho diagnosis is not rocket science. You need to understand that to have such good life style, we had to sacrifice a lot. We often get ridiculed by our classmates for working so hard in dental school (well, I didn’t have to go through this since I went to a non-competitive P/F dental school). We spent 2-3 extra years and borrowed $50-200k for the ortho residency. Despite the warnings from many practicing orthodontists (such as Dort-Ort, QCkid, Firm etc) that ortho is a dying specialty, many dental students and practicing dentists still try apply to as many ortho programs as possible to increase their chance of acceptance….This is a huge risk, don’t you think?

I apologize Charles, but this is not making any sense. why would I care about your compensation or your lifestyle. Last time I checked OS and Endo were also competitive and also made the same money (or more). It was your choice to take the risk (lets call it investment), as it was my choice to invest in my office.

Monreal, I know you also had to sacrifice a lot to get to where you are today. How do you feel when people think you are greedy dentist?...just because you spend less than 30 minutes to restore an implant and get paid $1000. Would you show a rookie dentist how to restore implants when you know his practice is just a few block away from yours?

I did not say you guys are greedy. You are not different than any other professionals, but I said you are seen as greedy because of the non-sharing attitude and that I understand why you have to do so.

As a GP, you can legally do ortho and who care what the orthos think. If you really want to learn ortho, read the Proffitt’s textbook instead of asking my ortho colleagues for help. The book is much more helpful and a lot cheaper than the weekend ortho courses for GPs.

I tend to think as a team player and I do care what the orthos think. I want to do a bit of everything, but at the same time know that the people I refer to will bail me out. If I break a file once every 2 years I expect my endo guy to say the truth: "this is an accident that happens to anyone" and expect my os to advise me what AB to use for sinus infection. Similarly I wish I could get on the phone with an ortho asking them why I am getting an openbite using this and that when I am not supposed to... just an idea.

 

[monreal]

Thank you for the post. Somebody needed to put that in writing. I find it funny that it seems like ortho's are the one's being called greedy! Last time I checked it wasn't easy getting into ortho? Nor was it cheap? I guess someone gave you that education for nothing...

I think "deserving" is a better adjective than "greedy".

How many GP's will actually pick up Proffitt and read it Charles? The answer is none- that takes effort and you don't get paid for it.


Pay some Ortho 100k (like they paid in tuition) plus 400+k ($ lost for the extra 2-3 years school) and I'm sure they will gladly teach you GP's ortho.

Sheesh- when I hear this crap it makes me cringe. Calling ortho's greedy and then poaching easy cases and letting them do the hard work (treatment planning a case where a kid's face can get F*$ked up is actually hard work) makes you sound GREEDY dude.

I think they should let hygienists start their own practices and place fillings/single unit crowns. Buccal pit composites are not rocket science....

Always the same obsolete discourse and money talk from a thread to another. A couple of words for you:

- I do not care how much it cost to be an ortho or how much you think I should charge for my ortho. I am talking teamwork and patient care.
- Hell sure I am gonna send you the crappy cases, isn't this why you had extensive training and, to speak your language, you're charging double my fees?
- You should really sue that GP who fu*ked up your face when you were a kid or else stop talking about it.
-Hygienist do NOT do restorative in hygiene school, hence they are NOT to do restorative. Dentists DO ortho in dental school, hence they CAN do ortho. For that reason, your example is as convincing as the rest of your post. Actually, if hygienists start doing restorative it is gonna affect specialists more than GPs because more GPs will seek CE course to do more specialists things, so good luck to you bud.
-Seriously, Good luck.

 

[monreal]

I used to think like you when I was still in the residency. Trust me, when you have your own private practice and you have to pay back your student loans, office rents, business loans etc, you will think differently.

You are 100% right Charles. No one will pay your bills for you. But this is all because you guys can always handle more cases, unlike endo for an example who can only do 4-5 molars/day + few consults. So they actually do not mind if the GP picks up few easy cases. You guys probably should golf more often .

I appreciate your civilized discussion, which actually makes sense.

 

[GTFOOMICT]

Actually, if hygienists start doing restorative it is gonna affect specialists more than GPs because more GPs will seek CE course to do more specialists things, so good luck to you bud.

I agree with this fully 100%. The GPs will adapt and will always have the first stab at patients. Specialists will still survive.

I do question how profitable ortho is for someone who dabbles.

 

[monreal]

I agree with this fully 100%. The GPs will adapt and will always have the first stab at patients. Specialists will still survive.

I do question how profitable ortho is for someone who dabbles.

Exactly! Everybody will still survive; there is enough patients for everyone. And no one has the right to be upset for not referring.

Not as much profitable as everyone thinks, at least in my practice. Lack of trained staff, limited space and poor logistics make it time consuming at the GP's. But I still do some because I like it.