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Henry Schein Orthodontics

For John Graham, DDS, MD, who joined the Henry Schein Orthodontics’ (HSO) Clinical Advisory Board at the start of the year, the HSO Orthodontic Excellence & Technology Symposium in Scottsdale, Arizona, in February, was opportunity to showcase the work the Clinical Advisory Board is doing to create real solutions for orthodontists.

According to Graham, his decision to join the HSO Clinical Advisory Board is in large part due to the leadership of the division’s new general manager, Ted Dreifuss. Graham has been closely aligned with orthodontic manufacturing since entering orthodontics 10 years ago. He loves the brainstorming that comes with creating innovative products and working with an engineering team that can execute an idea. However, the challenge of moving his practice from Phoenix to Salt Lake City a few years back forced Graham to put these types of projects on the back burner. But with Dreifuss at the helm, Graham saw an opportunity to get back to what he loves.

“Ted has recreated all that with Henry Schein Orthodontics, and it’s beyond stimulating. It’s so fun because we tackle issues, we try to improve existing products and come up with new ones. The engineering team has got such a can-do attitude that they’ll try anything,” Graham said during our interview ahead of his lecture at the Symposium.

For Graham, a number one priority of his work on the Clinical Advisory Board is creating solutions for orthodontists that reduce treatment times. “Anything that we can do as a company to shorten treatment time without sacrificing the quality of the outcome is a real motivator for me, and, I think that on the team, we all sort of share that common vision.”

In line with this goal of creating solutions to reduce treatment time was Graham’s lecture, titled “SAGITTAL FIRST: Transforming Today’s Orthodontic Practice.” For Graham, the SAGITTAL FIRST philosophy moves the heavy lifting of orthodontic treatment to the start of a patient’s care.

“The heaviest lifting we do as orthodontists in the course of somebody’s treatment is the AP correction, and, sadly, the way that we’ve always done it—and the way most currently teach our young residents—is that after [the patient] has been in treatment for about 9 months to a year, when the patient sufficiently hates you and is completely and utterly burned out, you introduce the idea that you need full cooperation or they’re not getting out of braces. It mystifies me that we haven’t come up with a solution before now, because it is a primary hurdle that we have in our practices, and it’s a common hurdle that we all share,” Graham said.

“The SAGITTAL FIRST philosophy allows us to capitalize on the orthodontic patient’s mindset. They know when they go to the orthodontist to start treatment that their life is about to radically change. Routines are going to change. If we can capitalize on the heaviest lifting portion of their treatment in that first 3 to 4 months, then everybody wins. They don’t get burned out. They correct very quickly. And the marvelous thing is, they don’t even have to decide if they want clear aligners or braces [at the start of treatment].”

For Graham, who fully implemented the SAGITTAL FIRST philosophy into his practice 3 years ago, AP correction, whether Class II or Class III, is typically achieved in 3 months with the Carriere Motion 3D Appliance. As he puts it, the clinical aspects of the SAGITTAL FIRST approach are straightforward and easier on the patient. In addition, the approach cuts down on emergency appointments. According to Graham, the real work a practice needs to put into implementing this philosophy is getting systems in place.

“It changes your scheduling construct when things are happening at a rate that’s almost twice as fast as they were before. When you’re doing sagittal correction, there is an impact on the practice—but every single impact is positive. It is a legitimate change in treatment philosophy that has a real impact on a practice and it’s exciting,” Graham said.

During his lecture, Graham spoke about how implementation of the SAGITTAL FIRST philosophy brought both qualitative and quantitative benefits to his practice. “I see more patients now because of [this approach]. Empirically, it’s increased my revenue because word is out that treatment in my office happens relatively quickly and comfortably. Patients don’t want to be in braces for 2 years.”

And for those who worry about an increase in patient defaults because the patient completes treatment well before paying in full, Graham pointed out that the data doesn’t support that notion.

“The data we got out of OrthoFi is that the vast majority of people that default on their contractual obligations do so within the first 6 months of treatment. So, it doesn’t matter what you’re doing. The vast majority of those patients will declare themselves early on. It isn’t the patients who have been out of treatment for 8 months.

“[The SAGITTAL FIRST approach] is a huge [paradigm shift] because of the way it impacts both the financial and time management aspects in the practice and the way you end up marketing by word of mouth. You really maximize the brief 12-month or so time that you have these patients. It really forces us to be on our game all the time, and, to me, that’s incredibly stimulating,” Graham added. OP