Orthoease

Success the Dr. Thomas way!
Taking over a failing practice, installing new technology and making it profitable

Please introduce yourself to our readers. When and from where did you get your undergrad and dental school degrees?
It’s a pleasure to share my background with your readers and express the passion I’ve found being an orthodontist. My undergraduate education was at my hometown college — the University of San Diego. USD preparedme really well for dental school with a solid basic science curriculum. I also enjoyed playing football and was one of the captains my senior year. After USD, I attended Georgetown University’s dental school in Washington, D.C. and received my orthodontic certificate from their ortho program in 1989.

Why did you choose to specialize in orthodontics?
Nothing appealed to me more than orthodontics. From my own early experience with braces, I knew that straight teeth and a great smile contributed to having a better life and increased self esteem. Who doesn’t love a great smile?

How long have you lived in San Diego? Why did you choose this location?
Actually, I was born and raised here in San Diego. I’m probably one of the few native San Diegans who’ve stayed in town their entire life.

You took over an already existing practice instead of starting your own. Why?
Right out of my ortho residency, I opened my own practice — that was almost 18 years ago. If I had it to do all over again, I’d choose to associate or find a mentor to continue learning business and treatment modalities right out of school. Unfortunately, those choices are not readily available. This is the reason I now volunteermentoring new doctors, and currently have five who visit the office and keep in touch about cases through e-mail. Six years ago, I bought a practice where the doctor had recently retired and had not made a single improvement from the time he first opened it 30 years ago.

How was the practice doing financially when you took over?
This particular practice I bought six years ago had been driven into the ground — grossing only $120k the year before my arrival. It was in desperate need of rebuilding on every level. We’ve grown the practice, which grossed over $1.8 million last year; we’re on track to do even better this year.

What services did you institute in order to make the practice more profitable?
We’ve incorporated and integrated many critical processes over the past six years that have helped us become more profitable, while at the same time dramatically increase our quality of care. First was the integration of OrthoEase as our practice management software system. This practice management system was a perfect fit for our practice. I’d used other programs in the past where support fees, in my opinion, were really out of line. That’s not the case with OrthoEase. The second addition was a total conversion to the Damon System, which continues to impress and amaze me with its high-quality results and streamlining of treatment through well-established systems. In the past, I’ve used many techniques, including Roth, Mulligan, Andrews and MBT, and nothing compares to the results I see since changing to the Damon System. When I first set out to learn about the Damon System, I really put it to the test. My first 30 cases were photographed during each and every appointment, progress records at six months, and I followed Dr. Damon’s teachings to the tee. To my huge surprise, my cases looked every bit as impressive as any I’d seen in his lectures. I’m committed to helping other doctors experience everything the Damon System has to offer, which is why I am one of 12 certified Damon Instructors nationwide. We provide Damon System training courses in our office in Poway, Calif., on a regular basis. The next two training sessions will be held April 18-19 and Sept. 26-27 of this year. Doctors and their staff can call (858) 748-6200 for information about these sessions. Two additional components were critical to our growth. It’s vital for an office to reflect excellence — this motivated us to completely remodel our practice inside and out. We also improved our Web site (powaybraces.com) and made sure search engines found it quickly on the first or second page. If any readers don’t know about search engine optimization, I highly recommend they find out how to do it. The final piece required for quick growth was an aggressive internal and external marketing plan, which was put together and implemented by my wife, Scarlett, through her company Orthodontic Management Solutions (www.orthoconsulting.com).

Please describe what OrthoEase does for its users/clients, and what it is has done for your practice specifically.
OrthoEase has been remarkable for our practice in so many ways. Their commitment to excellence impresses me as does their prompt efforts to return support calls. I’m particularly impressed that the owner/programmer (Dr. Peter Kimball, a high-quality orthodontist) makes the process of delivering a product that helps orthodontists manage, grow and enjoy their practice his No. 1 priority. They also hold user meetings, which helped us learn to use a great majority of their programs features. Most exciting is the recent release of version 7. Our practice uses both Macs and PCs, and this program is the only one I know of which is dual platform compatible in a pure sense.

Please answer the same question regarding the Damon System.
The Damon System has revolutionized the way I practice orthodontics — pure and simple. Inherent within this system is a focus on excellence — envisioning the end in mind — and treatment planning to arrive at that destination in the most efficient manor possible. Let me give an example. For most orthodontists, they use one prescription for each and every case—many use the same Roth Rx. The serious downside to this is that our patients are not alike — Class II cases have differentmechanics and requirements than Class IIIs. The Damon System is organized down to specific case requirements and taught to fully understand how cases need to be thought out fromthe beginning. Often, Mx lateral incisors are palatally blocked out with the root far more lingual than ideal. The Damon System teaches us to think about requirements for obtaining ideal root position — either use low torque (+3) or flip a high-torque racket upside down (+10) to allow the high-tech copper NiTi wires achieve the movement as efficiently and biologically compatible as possible. Should a doctor desire even more help with labial root movement, they can choose to place a high-torque Mx central incisor bracket flipped upside down. This gives +17 labial root torque. Another facet of the Damon System inherent to tooth movement is understanding play within the slot of a tube, versus play within the slot of an active clip. There are huge benefits to a passive “tube” and large lumen size, especially in the initial unraveling of crowded cases. For me, the bottom line is always about excellent patient treatment results, and this system has shown me that fantastic results can become routine with far fewer visits.

Please describe the compatibility of OrthoEase and the Damon System, and how it has worked for your practice.
OrthoEase and the Damon System have similar goals: increased efficiency, reduced numbers of appointments, and increased quality of treatment results. OrthoEase helps to achieve this by enabling me to view treatment plans, treatment time, percentage of treatment completed, and numbers of appointments to date — in a single glance. It also shows me my estimated treatment time and where the patient is in their treatment at a quick glance. How many times do our patients ask “how much longer?” With OrthoEase, answers are often found immediately on the patient’s treatment card right on the main patient treatment screen. The Damon System is entirely compatible with OrthoEase because their owner/programmer is an orthodontist who is a Damon user. We’re spending a great deal of time integrating Damon features into OrthoEase that allows, for example, custom selection of bracket torques at the initial exam right into the patient’s chart. This allows chairside assistants the ability of setting up cases accurately for the bonding appointment. During our initial exam, I inform my treatment coordinator which bracket torques are required for the case. She inputs that information into the patient’s treatment plan and it’s clearly displayed on the patient’s chart, helping chairside assistants set up the brackets correctly and customized for that case.

In your opinion, what are the main concerns or problems in the field of orthodontics today?
In my opinion, the main problem in the field of orthodontics is how many individuals appear to be highly concerned about preserving their particular mode or philosophy of treatment and dogma, rather than being open-minded toward newer ideas. For example, many orthodontists in education blast the Damon philosophy and refuse to allow the technique into their curriculum or presentations. Along with that are statements saying “Show me the proof.” Most research data is typically generated by these same institutions, and when they refuse to legitimately integrate and study this new philosophy, what does that say about our really wanting to improve our specialty? I wholeheartedly support evidence-based research and implore orthodontic departments to begin studies on the Damon System. Is it possible that over 1 million completed cases worldwide with incredible smiles, occlusions and high-quality results, are wrong? When well-intentioned educators preach about how it does not work and yet have never experienced this method of treatment (correctly following outlined protocols), how can that benefit anyone other than the particular technique/philosophy they embrace? What matters more to our specialty — great smiles, fantastic faces, greatly improved occlusions, reduced discomfort, far fewer appointments, far less extractions — or planting our feet deep into the been done? Laws of physics do not change, but is it possible that our understanding of these laws become better understood as they relate to the biological system?

What do you think can be done to correct the problems that you see?
With the strong push toward evidence- based orthodontics (which I support), it’s imperative orthodontic educational programs support research of all kinds — not just their pet projects. Unfortunately, I doubt this will happen in the near future. In my opinion, it’s outrageous that a majority of the orthodontic programs in the United States refuse to allow the Damon System into their curriculum and yet this is the one ‘system’ that’s revolutionizing clinician’s practices all around the world.

Are there any other comments you would like to share with our readers?
Yes, I’m glad you asked. The field of orthodontics is changing in ways most are now feeling. Starts are way down over the past six years and this trend looks like it’s going to continue. In my opinion, there are specific reasons for this: general dentists treating everything in sight with Invisalign (22,800 cases submitted Q2 07), instant orthodontics with veneers, and an exasperated public tired of excessive treatment times, extractions, surgical procedures, pain, dissatisfied orthodontic results. When Invisalign was sued by general dentists to gain access, it was stated that a few would be trained each year — to date 10,100 dentists have had cases shipped. Has anyone else evaluated what will happen with Sure Smile once general dentists come into the picture? Competition is fierce, which is why advertising has evolved. Referrals to my practice from general dentists are way down, yet my case starts are way up. This is not a coincidence. Referrals to my practice by patients have risen dramatically. Our results must improve and treatment times must come down (published 30 month average treatment time). The public has spoken by the fact that most orthodontic offices are not as busy as they used to be.

We heard you spoke at the Damon Forum in Phoenix, Ariz. Can you tell us about the Forum and your lecture?
Absolutely! It was the most exciting meeting that I’ve ever attended and highly recommend it to anyone really wanting to learn what the Damon Forum has grown to over 2,000 attending doctors and staff — can you believe it? My presentation/ lecture series was on understanding bracket torque selection and how these choices are directly influenced by specific case requirements. Case-specific bracket torque customization is critical to efficient case management, and is the one area most recent graduates lack understanding. I know my graduate education never even discussed custom torques — let alone the “straight wire appliance.” Our program was using 0,0 appliances with the belief that we must know how to ‘bend’ wires. Today, understanding how to custom- select prescriptions based upon tooth-by-tooth and case-by-case requirements, use of high-tech archwires, understanding wire size, slot size, active clip or passive clip, are all absolutely critical to enjoying efficient, well-controlled case management and treatment when using any type of mechanics — self ligation or otherwise.

About the author
Dr.William Thomas is in full-time practice in Poway, Calif. A diplomate of the American Board of Orthodontics, he is a part-time instructor in UCLA’s orthodontic department, a certified instructor for the Damon System, and a speaker at the Damon Forum from 2006-2008. He spoke at the AAO meeting in Hawaii in 2002 on straight wire mechanics. He graduated from Georgetown University School of Dentistry and Georgetown’s orthodontic program with a Masters of Science Degree in 1989.

Contact
William W. Thomas, DDS, MS
Phone: (858) 735-2285
Email: drt@powaybraces.com
www.powaybraces.com