SAO News September 2020

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September 2020

SAO LEADERSHIP President Dr Jeri Stull Fort Thomas, KY


President-Elect Dr Sims Tompkins Columbia, SC Secretary-Treasurer Dr Eric Nease Spartanburg, SC First Senior Director Dr Mark W. Dusek Savannah, GA

President’s Message – Jeri Stull ............ Page 2 SAO Annual Session 2020: A Meeting Experience Like No Other! – Debbie Sema ............ Page 3 SAO Annual Session 2020 List of Speakers and Topics ............ Page 4

Second Senior Director Dr Debbie Sema Birmingham, AL Third Senior Director Dr Beth Faber Tidewater Region, VA Past President Dr Anthony W. Savage Virginia Beach, VA

AAO Trustee’s Report – Richard A. Williams ............ Page 5 Oren Oliver Distinguished Service Award – Brian Jacobus ............ Page 6 Sharon Hunt Emerging Leader Award – Chris DeLeon ............ Page 7

AAO Trustee Dr Richard Williams Southaven, MS AAO Trustee at Large Dr Alexandra Thomas Spartanburg, SC Speaker, AAO House of Delegates Dr Jeff Rickabaugh Winston-Salem, NC Director, The American Board of Orthodontics Dr Tim Trulove Montgomery, AL

In Memoriam – Russell P. Greer ............ Pages 8-9 In Memoriam – Robert Hazel ............ Page 10 AAO Political Action Committee Report – Greg Inman ............ Page 11 How Would YOU Treat This Patient – Timothy Shaughnessy ............ Pages 12-15

SAO CONTACT INFORMATION Ms Heather Hunt Executive Director 32 Lenox Pointe Atlanta, GA 30324 Phone: (404) 261-5528 Fax: (844) 214-1224

Five Questions Prospective Patients Have When They Reach Your Website – Mike Fitterer, Sesame Communications ............ Pages 16-17


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September 2020 I would like to thank the membership for the honor and privilege of serving as President of the SAO. I want to thank all the dedicated leaders with whom I have had the pleasure to serve since becoming a Component Officer for Kentucky in 2002. I count many of these leaders as my closest friends and mentors. This is the true gift that anyone can receive if they get involved. As you read this, I want you to take a moment to reflect on those who left a legacy for you to follow in life, Parents, Educators, Innovators, Mentors, and Friends. What is your vision for the role you will personally play in the future of Orthodontics? My hope is that you will choose to leave a legacy of leadership, innovation, mentorship and engagement.

President’s Message Jeri Stull

You can’t always get what you want, but if you try sometimes, you get what you need.

– The Rolling Stones

We didn’t get what we wanted, which was to attend our amazing live meeting in Nashville that we had been planning for over four years. However, during these difficult times we are getting what we need – a meeting format that is both virtual and interactive. Polaris by OrthoScience is allowing us to bring the best of both worlds to the SAO 2020 meeting. This learning platform is so different from anything we have experienced in a virtual meeting space. It was built for Orthodontists by Orthodontists! It is designed for how we communicate and think. We believe that it is critical to allow our members the opportunity to explore and understand this technology, so all members will have the opportunity to access the SAO Room. In the next few weeks all SAO members will be invited into the SAO meeting room on Polaris by OrthoScience at no charge – just watch your email for the invitation.

When the SAO 2020 Meeting goes live, only registered guests will be granted access to the entire meeting space. The program and speakers will have something for everyone: doctors, residents, staff, and new and younger members. Please plan to take advantage of the On Demand – total of 24 hours of CE that is available with this meeting. The virtual exhibit hall will allow interaction with the vendors by message and Zoom platforms. We will have scheduled Zoom Round Tables that will increase the opportunity for networking. Most speakers will have a hosted Zoom interaction for questions and answers during the last ten minutes of their scheduled lecture time. Also, please join us for the Zoom Country Music Happy Hour on Friday, October 16th with a taste of Nashville and ending the meeting, a Zoom Tailgate Party on Saturday! So be sure to represent your favorite college football team!

”Everyone goes through adversity in life, but what matters is how you learn from it.” – Lou Holtz


A special thanks to my Meeting Committee, its Chair, Dr Deborah Sema, and our Executive Director, Heather Hunt. None of us thought we would be planning our Nashville meeting for years but have only months to plan a virtual meeting. Thank you all for your dedication and hard work. On behalf of the Southern Association of Orthodontists meeting planning committee, we invite you to join us virtually for the SAO 2020 on October 16th and 17th, and on demand for six weeks following the live meeting.

Click here for registration and meeting information

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September 2020

SAO Annual Session 2020: A Meeting Experience Like No Other! Debbie Sema

2020 Meeting General Chair

Buckle up for an amazing experience October 16th and 17th. While we are all disappointed that we can’t hug, handshake, and honky-tonk in Nashville this year, Dr Jeri Stull and her committee have been working to make some seriously great southern lemonade out of the lemons launched our way. In true SAO style, we are taking our virtual meeting to a level that will change the way you think about digital meetings. We have proactively teamed up with OrthoScience and its Silicon Valley technology. OrthoScience is responsible for building Polaris, THE premier orthodontic sharing platform started by orthodontists and designed for orthodontists. You may already know that Polaris contains a powerful case repository with over 50,000 treated orthodontic cases for study and discussion. But this is just part of what OrthoScience does. The company’s technology will provide us with an amazing interactive annual session experience like no one has yet experienced. To fully grasp the “cool factor” of this meeting, you must imagine yourself and your team in an actual meeting. You can still choose to go to different lecture halls to hear some of the most sought-after speakers on the hottest topics in our world today, speakers from Barcelona to Canada, and of course, right here in the great USA. You can engage with these great speakers and each other during

their presentations, just as you would in a live meeting, with questions and comments via live chat. Stay in the doctor track lectures or sit with your team for great learning and sharing opportunities in a team track with renowned consultants and doctors. Please see the next page for a list of speakers and topics. Grab some lunch while you attend round table discussions and talk with all speakers and fellow attendees in live real time discussions via zoom conferences. Or head to the Exhibit Hall to ask a question or make a purchase. Find the booth you need and engage with your favorite rep who can talk with you about show specials and navigate you through the company’s latest products. Find a deal you can’t pass up? Invite a friend to meet you there so you can share it with them and talk about it together. Check our sponsor booths for times you can engage their key opinion leaders at their booths. Just like a live meeting! And you can’t stop us Southerners from having a great time! Unpack your favorite country-western gear and join us for a Friday afternoon Honky-Tonk Happy Hour, complete with live Nashville entertainment! Let’s meet together for drinks, snacks, and laughs with complimentary snacks delivered straight to your door from SnackMagic. While they may try to take our ACC and SEC football (ARE there any others?!) away from us, you can’t take us away from our football! Paint your faces and get on your game day gear to finish up the meeting Saturday afternoon with our football tailgating wrap-up session!


But wait! There’s more! Believe it or not, it still gets better! You will have the opportunity to “stroll” through the lecture and exhibit halls one week prior to the meeting. This pre-meeting experience will allow you to become familiar with the Polaris platform and our digital meeting space. There will be a lot to see. It will also allow you a sneak peek of every lecture and show special. This “sneak peek” will enable you to have your questions ready for the presenters and your favorite reps while they are available live during the meeting. And instead of having to say our good-byes on Saturday afternoon, we get to keep the meeting going! All of the great presentations and sponsor booths will be available within Polaris for us to continue to review, learn, and engage in discussion until November 30th. In true Southern style, we’re just making the party last even longer! So don’t miss out on the Meeting of the Year! Register you and your team now to join us for SAO 2020 Virtual Annual Session!

Register Today

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September 2020

SAO Annual Session 2020 List of Speakers & Topics

To view speaker, course descriptions and schedule CLICK HERE

Shannon Brockway

Dr Bart Iwasiuk

Dr Sean Carlson

Brad Kucharo

Everyone Ends Up Somewhere – Chart Your Course!

Aim High – Making Invisalign Available to All Growing Patients in Your Practice

Breaking Your Own Glass Ceiling: Five 3D and Airway Basics to Help Your Practice Thrive

New in Practice? Critical Financial Strategies for Success

Dr Shane Langley

Dr Luis Carriére

Maintaining Clinical Control and Efficiency with Aligner Therapy

SAGITTAL FIRST: Treatment Planning Transformed

Dr Mitchell Levine

Jaime Couden

Top 20 Elements Your Website Needs to be Effective for Converting More New Patients

On the Wings of Icarus and Daedalus: The dynamics of “Airway -Centered” Orthodontics

Dr Bill Dischinger

Dr Michael Mayhew

Sparking changes with clear aligners in a fixed practice

Innovative Products and Methods for Treatment Simplicity, Efficiency, and Excellence

Jackie Dorst

Dr David Paquette

COVID-19: CDC & OSHA Guidance for Ortho

Same Day Starts with In-house Printed Aligners, Using Motion

Dr Ben Fishbein & Amanda Floyd

Alex Rasmussen

Nothing Changes if Nothing Changes

How to Bring It Every Day: Practical Tips for Being Exceptional

David Forbess

Dr David Sarver

Navigating Financial Decisions All Orthodontic Practice Owners Face

The Missing Maxillary Lateral Incisor – Things Keep on Changing!

Paul Gange Jr.

Dr J Don Spillers Jr

Buckle Up! A Crash Course in Orthodontic Bonding

Digital Workflow and Phase I Treatment: Are You Ready?

Kayla Hoorelbeke

Charlene White

Covering Your Bases in the Orthodontic Sales Process

Behind the Scenes of a 5 Star Team!


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September 2020

AAO Trustee’s Report Richard A. Williams AAO Trustee

To say that this year has been unusual would be one of the greatest understatements of all time! What we

all feared as we entered the new millennium in 2000 never materialized, however it seems to have shown up some twenty years later. I cannot help but think of our former Executive Director, Sharon Hunt, and her reminder to all of us that we must be nimble and adaptable in order to survive and thrive. Those concepts have not been optional for the AAO and its leadership over the past months: they have been required in order to meet the everchanging situational demands for our members. One such endeavor was initiated by one of our own, Gary Inman, shortly before the end of his tenure as AAO President. Gary created the COVID-19 Task Force in order to help advise our leaders and members on how to respond to the virus with the most up to date recommendations possible. This Task Force is rather large 15 people. There are Trustees, educators, practice consultants, council members, members of the AAO legal team, the AJODO Editor, an infectious disease MD, and representation from Cozen O’Connor (our new advocacy firm in Washington DC). I have been privileged to be a part of this group (Knowing the president has its privileges!). Regular meetings started in March. Our purpose is to discuss topics and advise our members on the latest from regulatory bodies such as CDC and OSHA about appropriate use of PPE as we

reopen our practices. The AAO has also been able to provide our members with town hall meetings and numerous email blasts from firms such as CEDR HR and Cain Waters that assist our understanding of the PPP and EIDL loan processes, as well as the availability of HHS funds. Our task force continues to remain active and will likely remain so for the foreseeable future because this pandemic is not likely to disappear any time soon. This task force has been a very valuable benefit of membership as all of us seek guidance in order to navigate these uncertain times. We also saw the virtual House of Delegates function and take action to relieve financial pressures on our members by implementing a significant reduction in the CAP assessment for this next fiscal year. Because of the momentum of the CAP program and the ability to partially fund it from excess liquid reserves, we are not likely to see a reduction in the effectiveness of the program over this next year. The HOD also directed staff to delay sending dues statements until August 2020 in order to provide a two-month breather to allow members to get back on their feet before renewals came due. Payment terms have also been extended for up to 9 installments and an account direct draft program instituted with a one-time 3% discount for members to remit payments by this method. The financial health of the AAO and our solid reserves have allowed us to execute these actions without creating any financial hardship on our organization. It pleases me to report that at the end of August (one month of collected dues) we are at approximately 51% of dues collected for the fiscal year. This compares to a 39% collection rate for June in previous years. While we are comparatively ahead, catching up completely may be difficult to accomplish


in the short term. I am more convinced than ever of the enormous value of membership and encourage all of you to help us get back on track as you become financially able to do so. The Consumer Awareness Program has had another incredible year. The fiscal year ended with over 1.1 billion (yes with a “B”) views of our materials over all platforms. Our newest campaign, “Happy Mouth Now” has been recognized by Adweek and has already created over 10 million views in its short life. This campaign is a series of short videos pushed out on behalf of our members. They are very well done and I think all members will find them to be amusing and effective at driving our message about treatment decisions to consumers and decision makers. Being nimble and adaptable for our meetings and meeting planning has not been optional. We learned a lot in a short time this spring when we converted our AAO Annual Session to a virtual format. We are likely forever changed in the way we plan and conduct meetings. The Winter Conference to be held in Palm Desert, CA February 12-14 has become a hybrid event due to the necessity to limit attendance for appropriate social distancing. There will certainly be a virtual component that will make this meeting more accessible all around the globe. The Leadership Development Conference which normally precedes this event has moved to an all virtual format as well. Not being face to face will change the relationship aspect of the conference but, hopefully, we will overcome this hardship because developing new leadership is extremely vital to the AAO as well as to our constituents and components. Just as heat tempers steel, the menace of the coronavirus has necessitated a determination in our leadership and membership that moves us forward and ahead and makes us stronger. The AAO continues to strive to serve our members. Please be a part of making the future bright for those who follow!

Thank you for the privilege to serve! Richard A. Williams AAO Trustee

September 2020

2020 Oren Oliver Distinguished Service Award Brian Jacobus Service has defined Dr Jacobus’s orthodontic career. He has consistently given back to the specialty. His leadership

began early in his career with a term as the president of his local dental association. He also represented Florida’s Atlantic Coast district as a delegate in the Florida Dental Association. His first service to the Florida Association of Orthodontists (FAO) was as a member of the Expanded Duties Certifying Board. He was subsequently elected to serve on the Board of Directors of the FAO and later to its Executive Committee. His tenure as FAO President was a culmination of his eleven years of service to the organization. The Southern Association of Orthodontists elected Brian to serve as an At-Large Delegate to the AAO House of Delegates. Early in his SAO leadership experience he was asked to chair the SAO Annual Meeting at the Broadmoor in Colorado and was subsequently elected to the SAO Board of Directors. He served with distinction as he moved through the SAO leadership positions to ultimately serve as President of the SAO. Dr Jacobus’s dedication to the specialty led him to serve the SAO as a Delegate to the AAO House of Delegates after serving as SAO President. During that time, he also volunteered to be the General Chair for the 2018 Annual Meeting in New Orleans. Dr Jacobus has presented the leadership section to many of the SAO Leadership Programs. Clearly, Brian’s loyalty, dedication, and love for our specialty and the SAO are distinctive. Brian received his DDS from Georgetown University in 1978 and immediately joined the dental corps, United States Air Force. He received his Masters degree and a certificate in orthodontics from Georgetown University in 1985 and

returned to the Air Force for two more years. He and his wife, Kim, have three children – Brittany, Bethany and Brian Matthew (pictured above) – and are the proud grandparents of four girls! – Randy Rigsby

I am personally excited and proud to present the Oren Oliver Distinguished Service Award to my good friend and mentor, Brian Jacobus. Brian has always shown a passion for our specialty and dedication to our association. His examples of leadership, respect and hard work have been an inspiration to everyone who has served with him. All of these qualities are noteworthy but his true legacy is his role as an amazing husband to Kim, father, grandfather, and a friend to anyone lucky enough to know him! – Jeri Stull, 2020 SAO President

The criteria for receiving the Oren Oliver Distinguished Service Award include: • The individual must be an orthodontist and an SAO member in good standing. • The achievements of the recipient rise above the ordinary and are far beyond the normal expectation of member leadership and service to the SAO. • The achievements of the recipient go to the heart of and significantly advance the mission of the SAO • The award itself will reflect not only honor on the individual, but reflect credit upon the Association • The recipient has consistently supported the SAO with attendance at Annual Meetings.


Thank You from Brian Jacobus I sincerely thank President Jeri Stull and the SAO Board of Directors for bestowing this prestigious award upon me. It is with humility and much gratitude that I accept this award. It is an award that I never dreamed of receiving and I accept it knowing that I do not deserve to be on the same page as many of the giants of our profession that have been so honored. From my earliest days at the FAO and SAO people stepped forward, offered their assistance, their experience and mentored me, preparing me for my journey in organized orthodontics. The number of people to whom I am indebted is too numerous to name in this format and I would hate to miss anyone. There are four women that I would like to thank and to whom I dedicate this award. The first person would be my mom. From my earliest memories she taught me, through her quiet example, to be the best that I could be, respect those around me and remember that God was always there to help. The second person would be my wife, Kim. She has been my rock and without her love and support I would never have been able to take on the tasks that I did. It meant time away from her and my son and she was always there behind the scenes taking care of things at home. The third person is Lissette Zuknick, our FAO Executive Director. We came up through the ranks of the FAO together, she as the FAO Executive Director and I as a Board member. I could always rely on Lissette’s advice and counsel both professionally and as a good friend. And last but certainly not least was Sharon Hunt. Friend, confidant, mentor, advisor – it was Sharon, who like many of us, shaped me into an SAO leader. I will always be thankful and hold these four women dear in my heart. Thank you once again for this honor. – Brian Jacobus

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September 2020

Sharon Hunt Emerging Leader Award

In 2020, the SAO Board of Directors established the Sharon Hunt Emerging Leader Award to honor an emerging leader who has significantly advanced the mission of the SAO, Component Organizations, and/or the AAO. The purpose of this award is to recognize the recipient for outstanding volunteer service and contributions to our associations.

Sharon Hunt Emerging Leader Award Chris DeLeon Like all faithful Georgia Bulldogs, Chris DeLeon’s blood runs red and black. He was raised in Augusta and completed his undergraduate work at the University of Georgia. He continued his dental and orthodontic studies at the Medical College of Georgia in Augusta. After graduating from MCG’s orthodontic residency program Chris joined the practice of Drs Tom Broderick and Mark Dusek in Savannah, Georgia. He completed the SAO leadership class in 2015. Chris is active in organized dentistry and serves in several leadership positions. He organized and chaired a leadership program for the Georgia Dental Association. He is the GDA Southeastern District Give Kids A Smile program chairman. He serves as the representative for the Southern Association of Orthodontists on the AAO Council on New and Younger Members. Chris is the current President of the Savannah Dental Society. Chris DeLeon, a bright, hardworking, young leader, is a very worthy recipient of the Sharon Hunt Emerging Leader Award.

The criteria for receiving this honor include: • The recipient must be an orthodontist and member in good standing of the SAO. • The recipient should have ten years or less in volunteer leadership and service to the Southern Association of Orthodontics, Component Associations and/or The American Association of Orthodontics. • The achievements of the recipient should rise above normal expectations for volunteer leadership. The recipient’s achievements will be the model of outstanding volunteer service and leadership and serve as a role model to future leaders of our associations. • The individual should have been a successful participant in the SAO Leadership Program. • The recipient has consistently supported the SAO with attendance at Annual Meetings.

Chris has a distinct musical bent and enjoys playing guitar and harmonica. When not practicing orthodontics or playing golf and music, Chris and his wife Maggie enjoy spending time with their dog, Colonel (pictured above). –Mark Dusek


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September 2020

In Memoriam

Russell P. Greer

On August 22, 2020, orthodontics lost an iconic legend, Russell P. Greer. Russell Greer was a leader’s leader and an orthodontist’s orthodontist. There are few who have contributed as much to the specialty as this one man. His leadership skills were extraordinary.

Russell Greer served as President of the Kentucky Association of Orthodontists, the Southern Association of Orthodontists, the North American Begg Society, and the American Association of Orthodontists. To list his servant leadership positions does not, however, give one a true picture of the man nor of his leadership and interpersonal relationship skills. During every leadership tenure, Russell Greer made a positive difference for the specialty of orthodontics. The landscape that greeted Russell Greer when he started his practice was interesting – and a challenge. Russell received graduate training at the University of Tennessee, the first graduate program in the South. Many orthodontists who practiced at the time when Russell graduated from his program were preceptor-trained orthodontists. To add to the confusion, the American Association of Orthodontists determined that the university programs that existed at the time could not educate enough orthodontists to meet the demand of a post-war baby-boomer population. As a result, a preceptorship program was initiated by the AAO. This program added to the cadre of preceptor-trained orthodontists who were starting practices at the time Russell started his practice. There were many appliances in use at the time – Johnson twin wire, Crozat, Begg light wire, labio lingual, standard edgewise, etc. Those trained by a preceptor would be exposed to one or two of these appliances while those trained in a university were probably exposed to more of them because of the part-time faculty who were teaching in the university’s graduate program. The problem with all this was that there were “under the surface” rivalries between preceptees and orthodontists who were university trained.


While he was President of the Kentucky Association, President of the Southern Society of Orthodontists (now the SAO), and the AAO Trustee, Russell worked tirelessly to end the conflicts between orthodontists who were preceptor trained and those who were trained by the universities. For example, Russell Greer, when he was the AAO Trustee, suggested to a then-young Tennessee Director to the Southern Association that the Distinguished Service Award given by the Southern Association be renamed the Oren Oliver Award. This name change was done by the SAO Board in the mid 1980s. It not only honored the late Oren Oliver, the Southern and national leader of preceptor orthodontists, it also helped bring closure to preceptor/universitytrained orthodontist conflicts in the South and elsewhere. Russell Greer, because of his foresight and wonderful personalrelationship skills, did more than anyone else to get all orthodontists, both in the SAO and in the other AAO constituents, to forget the “imaginary divide” between preceptorship and university training. Russell Greer smoothed the transition to formal orthodontic education. Russell was continually interested in orthodontic education – how he could, in some small way, help to improve it for future generations. His father, James R. Greer I, was a family dentist in Tazewell, Tennessee. His son, Jim, followed him into orthodontics and is a Proffitt-trained graduate from UNC-Chapel Hill. Russell supported the University of Tennessee from which he graduated and made it a priority to attend programs given by the universities in his home state of Kentucky and at the University of North Carolina. He was in the first class of “students” who enrolled in Bill Proffitt’s very first miniresidency at UNC.

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After serving seven years as the SSO Trustee, Russell became the President of the American Association of Orthodontists. One of his priorities during his presidential tenure was to change the process by which Directors of The American Board of Orthodontics were selected. Prior to Russell Greer’s AAO Presidency, ABO Directorship was handed down from one ABO director to another. As AAO President, he worked tirelessly with The American Board of Orthodontics to make the selection process for ABO Directors more democratic and professional. In cooperation with the late O.B. Vaughn, the ABO President at the time, he initiated the selection process that continues to be used today. Russell was a great mentor for young people. His customary words to a young person were “Now let me tell you... ” and he would proceed to tell the person what he wanted him/her to think about and/or do! Russell did this in a kind, considerate, no-nonsense manner. Many orthodontists fondly remember mentoring sessions with Russell. When Russell called, you LISTENED! You were going to be the recipient of wisdom!

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Other than orthodontics, Russell Greer had another great passion – FISHING, particularly bass fishing. He gradually and carefully acquired a fleet of fishing boats, tons of equipment, and fishing “camps” on three or four lakes in Tennessee and Kentucky. He and his fishing friends had great trips to his favorite spots where they fished and told tall tales. A great joy in any person’s life, if that person was a friend of Russell’s and lived in proximity to one of Russell’s camps, was to be invited to an R.P. Greer camp for a fish or a grouse dinner. Those are very, very fond memories for me and for all Russell’s friends who were invited over the years. Another of R.P.’s passions was curing country hams. He and many friends bought and sugar cured over a hundred hams each year so that each could enjoy and/or give country ham to friends. R.P. was the Ham Boss for 30-50 helpers – all of whom loved him! He orchestrated the 10-month-long ham curing sessions for years and years – and gave the most wonderful slices of perfectly cured country ham to his many friends. He even sent rolls for your ham when he sent ham slices as Christmas treats!

Russell was a member of the Maxwell Street Presbyterian Church in Lexington where he served as a Deacon. He was the widower of Nancy Schroeder Greer and is survived by his second wife, Barbara, and four children: Mrs Paula Elizabeth Greer Berry, Dr James Russell Greer, Mr Gerry Calvert (Catherine Lynn) Greer, Mr Gary (Diana Christine) Greer; five step-children; seven granddaughters, one grandson and five step-grandchildren. He loved his family and constantly interacted with each of them. Russell Greer will be sorely missed by those of us in the specialty who knew him, loved him, and treasured his friendship, including his fishing and ham buddies – and by all the people in this world whom he impacted. Russell Greer was a mover and a shaker. He left his mark on all of us who remain. He made this world a better place than it was when he entered it. Our specialty is better – and fishing, telling tales and curing hams are better – because Russell Greer was here with us. – Jim Vaden


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September 2020

In Memoriam

Robert Hazel During the years he worked for AAOF, Bob Hazel developed pledging opportunities that were designed to build a strong financial basis for the AAOF, AAO’s charitable arm. Mr Hazel worked closely with the AAOF Board of Directors on fund-raising initiatives that have enabled the Foundation to provide $12.3 million to support junior orthodontic faculty. This funding consisted of 232 Fellowship Awards and 242 Research Awards. Approximately 80 percent of today’s graduate orthodontic department chairs/full time teachers have received support from the AAOF at some point in their respective careers.

On July 28, 2020, Robert Hazel passed away after a courageous battle with cancer. In May of 2018 Mr. Hazel retired from his 26-year tenure as Executive Vice President of the American Association of Orthodontists Foundation. He was the recipient of the 2018 Eugene and Pauline Blair AAOF Distinguished Service Award.

Mr Hazel was instrumental in organizing fund-raising efforts to provide AAOF support for the Craniofacial Growth Legacy Collection Project. This collection is composed of representative samples of irreplaceable longitudinal craniofacial growth records of approximately 1,000 children and adolescents who did not have orthodontic treatment. Many of these records are more than 75 years old! Complete sets of these records are in collections in a number of U.S. and Canadian universities. A veteran fund-raiser with more 40 years of service in the non-profit sector, Mr Hazel earned an Executive Masters in Philanthropy from the Center on Philanthropy at Indiana University/Purdue University in Indianapolis (IUPUI). Bob Hazel was a great friend of orthodontics and orthodontic education. His contributions and legacy will long be remembered and appreciated. – Eric R. Nease


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September 2020

AAO Political Action Committee Report Greg Inman It is hard to believe that we have now entered the sixth month of these crazy times that I refer to as Groundhog Days. To add to the craziness, this year will conclude with a presidential election as well as 435 House and 35 Senate races. As you already know, the AAO has been a strong advocate for its members during these unprecedented times. Much work has been done with the regulatory agencies (OSHA, CDC, HHS) to make sure orthodontists are heard when decisions about how to safely operate our practices are made. It is great to have our offices open and be able to see our patients. One never knows how much you miss something until it is taken away! Your AAOPAC has provided essential support at the federal level to ensure that AAO’s efforts support all AAO members, both as health care professionals and as small business owners. Some of these efforts include: •

Advocating for AAO members to receive small business owner COVID-19 relief benefits

Inclusion of AAO members in a Secretary of Labor declaration that employers with less than 50 employees are exempt from the emergency paid sick leave requirements

AAO urged members of Congress to support legislation designed to increase funding for the PPP and EIDL programs

Virtual meetings between AAOPAC Contributors and members of Congress have been held so that members of Congress are aware of AAO member concerns

Luckily, the February 2020 AAO Advocacy Conference was held in Washington, DC as scheduled. In attendance were 121 AAO members, 44 of whom were residents. These New and Younger Members carry strong, much-appreciated voices to Capital Hill because Congressional staff members identify with them. The conference started with a training session on the specialty’s perspective of key issues. This training helped prepare everyone for “Hill visits” to meet with the legislators and legislative staffs. The first day concluded with a dinner at which Rep. Denver Riggleman (R-VA), Sen. Martha McSally (R-AZ), Sen. Jacky Rosen (D-NV), and Sen. Thom Tillis (R-NC) spoke to attendees. Six other legislators met attendees at a dessert reception. The following day was spent on the Hill where AAO members attended 42 Senate meetings and 135 House meetings. Though there was a national decrease last year in both the total amount donated to AAOPAC and in the number of contributors, the SAO remained steady with nearly $100,000 given to support the AAOPAC. SAO members should be proud of the fact that this amount was nearly a third of the overall AAO membership contribution total. Thanks again to those that regularly contribute and to those who are new to the list. Any amount given is greatly appreciated. Rest assured that the AAOPAC Council, in collaboration with the Council on Governmental Affairs, works tirelessly to use your dollars wisely.


In closing, special thanks needs to be given to Gianna Hartwig, Government Affairs Specialist with the AAO. She tirelessly supports our council with our state and our federal efforts. She keeps us connected and prepared to react to all the possibilities, as they become available, to influence our legislators for the betterment of our membership and our patients. For example, she recently plugged me into a virtual meeting with Senate Majority Leader Mitch McConnell in order to make sure that he and his staff keep our issues on their respective minds. Your PAC support makes possible all of the these efforts that keep our offices running in a manner that best allows us to take great care of our patients. To those who support AAOPAC – THANK YOU! To those who have not yet supported it – PLEASE give it some serious thought. We need you.

Click Here to Contribute

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September 2020

How Would YOU Treat This Patient? Timothy Shaughnessy

A nearly 17 year-old male presented for orthodontic correction. He reported having had a Phase I treatment at age 10. Fixed appliances were limited to the available maxillary permanent teeth. Another orthodontist saw this patient at age 12. He referred him to an ENT physician for nasal airway evaluation when the patient mentioned that he could not breathe at all through his nose. Surgical intervention followed and included sinus reconstruction, turbinate reduction, adenoidectomy, and correction of a deviated septum. According to the patient, his nasal breathing improved for approximately one year and then returned to the pre-surgical status.

Figure 1: Initial Facial Photographs

The INITIAL facial photographs (Figure 1) reveal a straight profile, a hint of maxillary deficiency, and increased lower anterior facial height. There is an increase in maxillary posterior gingival display. The lips appear to be barely competent.

The INITIAL intraoral photographs (Figure 2) show moderate maxillary crowding and severe mandibular crowding. The maxillary incisors are noticeably protrusive, making the effective arch length insufficiency even worse. The molar and canine relationship is Class III bilaterally.

Figure 2: Initial Intraoral Photographs

The panoramic radiograph (Figure 3) clearly demonstrates that the maxillary left incisor roots are shortened prior to comprehensive orthodontic treatment. The premolar roots are also relatively short.

Figure 3: Panoramic Radiograph


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September 2020

Third molars were extracted prior to obtaining INITIAL records. The cephalometric radiograph and analysis (Figure 4a and 4b) confirm a skeletal open bite and Class III maxillary-mandibular unit length relationship. Prior to the start of orthodontic treatment, the patient and his parents consulted with an oral surgeon with expertise in both orthognathic and nasal surgery. The surgeon determined that the patient and his father have Binder Syndrome, a rare congenital disorder characterized by a flat under-developed midface and nose. Characteristics often include a reduced or absent anterior nasal spine, abnormal position of the nasal bones, and an acute nasolabial angle.

Figure 4a: Cephalometric radiograph and analysis

Figure 4b: Cephalometric radiograph and analysis

How would YOU treat this patient? The Treatment Plan The patient obviously wants his teeth straightened and maxillary incisor protrusion reduced. He is aware of his open bite and would like it corrected as well. Can this be accomplished without extracting teeth? If it is necessary to extract teeth, which teeth should be removed? Will jaw surgery be required? How will these decisions affect the stability of dental alignment and open bite closure? The patient and his parents are not opposed to surgery for functional and stability reasons, however, they do not have facial esthetic concerns at the outset, other than the width of the bridge of the nose. The patient indicates “structural correction” as his primary reason for seeking treatment.

The Treatment Plan Options Treat the patient via non-extraction and non-surgical correction by using ‘magic brackets’! Obviously, non-extraction treatment is not a viable treatment option. Further proclination of the incisors is contraindicated esthetically. Accommodating all of the teeth would open the bite further, certainly not close it. Both stability and periodontal support would also be jeopardized if treated via non-extraction therapy. In summary, such a plan disregards the patient’s problem list and violates every major tenet of a quality orthodontic treatment result.

Option 1:

Option 2:

Plan for maxillary surgical correction of the open bite and Class III dentition. The primary goal of pre-surgical orthodontic tooth movement is dentoalveolar decompensation in all three planes of space. This plan calls for extraction of the first premolar in all four quadrants, closest to the site of crowding. The extraction spaces will facilitate the alignment of teeth and decompensation of the protrusive maxillary incisors.

Another option to consider is a camouflage approach. Would it be possible to accept the existing skeletal relationship but manage to correct the dentition? The strategic placement of temporary anchorage devices might also be considered. Extraction of maxillary second premolars and mandibular first premolars may be better than extraction of all first premolars because of the Class III molar relationship. The stability of open bite closure may be more uncertain with the camouflage approach.


Quarter 3

September 2020

The Treatment Plan Chosen All four first premolars were extracted in preparation for orthodontic treatment and maxillary surgery. .018 inch fixed appliances were placed on all of the teeth. Round nickel titanium arch wires were used for initial alignment and decompensation. Almost all of the extraction sites were eliminated in the process and prior to any active space closure. The anterior open bite closed a surprising amount with maxillary incisor alignment and spontaneous retraction. This unexpected event was cause for reconsideration of the camouflage vs. surgical treatment option decision. Six months into treatment, rectangular nickel titanium arch wires were placed and triangular elastics added between the maxillary canines and mandibular canines-second premolars. .016 x .022 beta titanium (TMA) arch wires were placed three months later (+9 months) and halfway through treatment. These wires were utilized for the duration of treatment. Stainless steel wires were never used, in favor of the lower load/deflection ratio of the TMA wires and respect for the open bite liability.

Minor finishing bends were placed during the final six months of treatment and included step up and down bends of the canines and premolars, offset of the maxillary left canine, and lingual root torque of the same tooth. PROGRESS intraoral photographs (Figure 5) highlight the placement of the detailing bends. The torquing bend did not completely change the maxillary left canine in the third dimension prior to debonding and before the patient left for college out of state. Total time in active treatment was 18 months. No vertical elastics were used during the final three months of treatment and no noticeable bite opening occurred.

Figure 5: Intraoral Photographs

The FINAL facial photographs (Figure 6) obtained at age 18 illustrate mild lip retraction but no major change in profile appearance. The posterior gingival display when smiling is less obvious and may be explained by the increased coverage by the lips as a result of retraction. The mandibular anterior teeth are more visible when smiling.

The FINAL intraoral photographs (Figure 7) show good alignment of the teeth, Class I posterior occlusion, and positive overbite. A fixed retainer was placed in the mandibular arch and crossed the extraction sites to prevent space opening. In the maxilla, two retainers were provided. A vacuum formed retainer was recommended for daytime wear initially with the intent of applying intrusive forces to the posterior teeth. A Hawley retainer with mattress springs behind the lateral incisors was also provided to prevent lingual relapse of these teeth. The tendency for bite opening will be monitored with this combination. A fixed retainer will be considered in the maxilla; however, the highest current priority is retention with excellent ease of brushing and flossing of the maxillary incisors.

Figure 6: Facial Photographs

Figure 7: Facial Photographs


Quarter 3

September 2020

The post-treatment panoramic radiograph (Figure 8) shows minimal increase in the preexisting root shortening of the maxillary left incisors. There is now evidence (but to a lesser extent) of some root resorption of the maxillary right incisors following time efficient and respectfully low force comprehensive orthodontic treatment. The post-treatment cephalogram, its tracing and the cephalometric values (Figure 9a and 9b) confirm retraction and retroclination of the protrusive maxillary incisors and minimal increase in the skeletal open bite. The pretreatment/post-treatment superimpositions (Figure 10) confirm that the open bite was closed by retraction and extrusion of the maxillary incisors, but greater extrusion of the mandibular incisors. Vertical growth of the nose and upper lip helped to offset the maxillary anterior extrusion and resulted in less posterior gingival display.

Figure 9a: Post-treatment Cephalogram

Figure 8: Post-treatment Panoramic Radiograph

Figure 9b: Post-treatment Tracing and Cephalometric Values

Anyone practicing orthodontics has experienced an unexpected, poor treatment response, despite our best effort to plan well and be conscientious. It is nice to see that it can go both ways. In this example, I genuinely started treatment planning for maxillary surgery but ultimately treated the patient without. The patient is now consulting with the same oral surgeon to explore options for improvement in nasal breathing. To be fair, the patient has not been out of treatment long enough to be comfortable with the stability of open bite closure. If this patient could breathe well through his nose and have relaxed, resting facial musculature, it would go a long way in increasing that comfort level. YOU may have treated this patient differently, and that is completely acceptable. This case report is presented to illustrate one way-and not the way I initially planned. I trust that your treatment plan, even if different than mine, would absolutely include the extraction of teeth. There are no magic brackets! Figure 10: Pre-treatment/Post-treatment Superimpositions


Quarter 3

September 2020

Five Questions Prospective Patients Have When They Reach Your Website Mike Fitterer


Sesame Communications

When prospective patients reach your website, they’re searching for answers to a number of different questions. But most importantly, they want an answer to one central question:


In most markets there are several orthodontic practices from which to choose. The Internet makes comparing these practices quickly a very easy task for most prospective patients.

“Why is this orthodontic practice the best option for my needs?”

So, standing out online relative to competitors is a necessity. In addition to being direct with your messaging about services, you MUST answer the “Why is this practice better than the other options?” question.

This article provides answers to these questions and covers a range of topics from design, to customer testimonials, and even site navigation.

Do you offer a unique treatment option? Do you have a rewards system? Are you the highest-rated orthodontic practice in the area?

So, let’s get started! 1

What makes you better than competitors?

Whatever it is that you do better than competitors must be quickly made apparent to your website visitors. Otherwise, you’ll just blend in with the pack.

What services does this practice offer?

Does this seem like a very simple question to answer? Good! It should be.


Too many orthodontic practices focus on the esthetics of a website instead of the message. Don’t get me wrong – a visually appealing website is a great marketing tool but beauty and functionality must be balanced.

Why should website visitors trust you?

Before becoming patients, website visitors often have little reason to trust your practice. If they don’t already know one of your current patients, they’ll have no reassurance about your practice’s ability to serve them.

Great practice website homepages feature front and center the services rendered to patients. Don’t make people guess what you do! Tell them right away.

In such scenarios, statistics and testimonials can be of great importance. Rather than believing your word, they can look at 3rdparty sources for building trust.

For example, on the Sesame website, the top of our homepage says “WHAT WE CAN DO FOR YOU.”

For example, if you have a very high patient satisfaction rating, mention it on your website. If you can save the average person time or money, say so! If you have many happy customers, grab quotes from a few of your best ones and place them in an obvious location on your website.

Don’t try and get fancy with your homepage messaging. If you’re an orthodontist in Seattle, say that! At Sesame we have an entire page dedicated to case studies to help provide supporting proof that we’re great at providing digital marketing solutions for practices.


Quarter 3

September 2020

4 What’s the next step?


If someone visits your website and is interested in learning more about your practice, they’ll need to know how to proceed.

How do I find more information?

What’s the best way to help a website visitor navigate to additional information? Make a very obvious navigation path of course!

Therefore, the impetus is on you to be very clear about the desired action you want prospective patients to take. For example, do you want them to contact you? Say so via a frontand-center button that lives in a visible spot on every page of your website.

In many cases, prospective clients may need to navigate through your website to find what they’re looking for. The more obvious you can make the website structure, the easier it will be for people to find the relevant information for which they are searching.

You also need to ensure the button or link to the contact form has a unique look and color versus the surrounding content so people can visually locate it quickly.

It’s common for Sesame website visitors to be interested in different service offerings. Consequently, we’ve created a site navigation that features a link to each service offering, as well as the available resources we offer.

As an added bonus, a clear site hierarchy will make it easier for search engines to crawl your website, which improves the likelihood of your website ranking well for important search terms.

In short, if you can effectively answer the “Why is this orthodontic practice the best option for my needs?” question by covering

each of these 5 points, you will place your practice in a very good situation for attracting new patients.


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