An Orthodontist’s Deep Dive into the Damon Ultima System

Alison Werner:

Hello. This is the Orthodontic Products Podcast on the MEDQOR Podcast Network. I’m Alison Warner, chief editor of Orthodontic Products. In today’s podcast, sponsored by Ormco, I’m joined by Dr. Michael Bicknell, an orthodontist in private practice in Illinois. We’re going to be talking about Ormco’s Damon Ultimas, its features and how it has impacted his case finishes and his practice’s productivity. Dr. Bicknell, thank you for joining me.

Dr. Bicknell:

Yeah. Well, thank you for having me. I’m really excited.

Alison Werner:

Great. Well, tell me about your practice. You have two offices, one in Elmhurst, another in Forest Park, which is I guess east of Chicago?

Dr. Bicknell:

Yeah.

Alison Werner:

How long have you been in private practice, and what stands out to you about these two offices?

Dr. Bicknell:

So yeah. I have two private practices. Originally out of residency, I began my first practice from the ground up, and quite honestly, in an environment that wasn’t really the norm. So that was the one that I built in Elmhurst, and I learned a lot as that practice grew through the early 2000s and into past 2012, ’13, ’14. I had an opportunity in like 2016 to purchase another office in Forest Park that was already established. And that was quite another learning moment, because when you start something from the ground up, you can make all the decisions, but when you acquire something, you have to keep a lot of what’s been done, and slowly merge the two together. So what’s really fun about these two is that even though they’re only nine miles apart, and they’re both essentially suburbs of Chicago, they’re two totally different patient populations. And what it means is every major urban city has a few of these towns that are these little bubbles that have pretty good affluency, it’s really, really steady.

There’s not one main industry that fuels this town. It’s a town of 50,000 people. And it’s pretty funny because in a town of 50,000 people, I think there’s about 15 orthodontists that live in my town, yet I’m the only one that truly practices in town. It’s just a great place to live. I think in 2002, it was rated the second-best town in the United States. So it’s just one of those. Forest Park on the other hand, is a town directly adjacent to Oak Park, Illinois, which is like Hemingway, Frank Lloyd Wright, it’s just inside the Cook County, but right outside the city of Chicago.

It’s very urban. So what’s cool is that one is really suburban, and the other one is quite urban. So our patient demographic is a lot different. And what we find about these two practices is you can see one commonality, and the commonality is whether it’s a suburban practice or an urban practice, is that our patients just want the best. They want to be treated in an amazing way, they want results that you can commit to, and they don’t want to waste a lot of time. And whether it’s kind of a classic suburban location, or a little bit more of an urban location, the value set and what we try to bring as the commitment to our patients is the same for both practices. So it’s just really fun to have two different locations that have a very different demographic.

Alison Werner:

With those demographics, do you see a difference in what they want in terms of aligner versus bracket treatment?

Dr. Bicknell:

You know, I think we used to. I think in ’17, ’18, ’19, I think in a lot of practices there was this kind of newfound push for aligners, and I think that that’s backed off just a little bit. Maybe it was because of COVID, maybe it was because it’s not the new shiny toy anymore. But yeah. I do think that funny enough, demographics dictate products at some level. The aligner companies were heavily marketing teens, and there was a big push in our suburban location for teens to get what they want.

Not that parents in these nice affluent communities give their kids everything, but I think kids have a little bit more say in what happens in their lives. And I think as parents in these communities, we try to encourage that. Where sometimes in the urban communities that we find is that the kids are just quiet, the parents tell them exactly what they’re getting. And I think that in our Forest Park location, there is a much heavier trend for people, both adult and kids, to want and request braces. In our Elmhurst location, they want to hear, what the doctor has to say, they want to hear what their child has to contribute. And it’s actually a much more open conversation, and we’re not in the position to tell them what they’re going to get, we try to steer them to the right product for them.

Alison Werner:

Okay. Do you notice with those patients who do want brackets, do you think they understand how brackets have changed, especially for the parents, since their youth, do you think they realize how they perform?

Dr. Bicknell:

I don’t think so. I really don’t. I think that at the end of the day, brackets are brackets to pretty much everybody. They’re not researching, and they’re also not coming to us because we’re using something that from a mechanical standpoint, has advantages. I think they’re coming to us, because of our experience, our views, our commitment to technology, and our commitment to treating people in an amazing way. So I think that that’s something that is lagging not only in our professional community, but also it lags a lot more in the patient community. It’s actually interesting sometimes when you talk about technology, patients don’t sometimes want it. They want, they’re like, “Wait. You mean I’m not getting colors on my brackets that my friends have?” And we’re like, “Uh.” And we’re like, “You can have colors, but the colored rubber bands have a purpose for some braces, and they don’t have a purpose for other braces. And we choose this technology for A, B, and C, and the colors are just kind of there to dress it up.

So if you have great hygiene, then you can have colors.” So no. It’s pretty funny. In a funny story I remember, we look at Google, we use the report, and I think we have I mean, probably six or 700 between the two practices. But I got a poor Google Review once, and it was from a teenager who said that I use junkie braces. And I read it, and they’re like, “He doesn’t use colors.” And I’m like, “Wait a minute. This is totally backfiring.” So at some level, it’s funny, and I’m sure that Ormco loves me saying this, but patients, they don’t care. Now, Ormco might be able to promote the Damon system, and some patients are tech-savvy, and when they are, they start understanding their options. However, that’s not the majority. I would say that’s 5% of our patients.

Alison Werner:

Yeah. So then it comes down to what you need.

Dr. Bicknell:

Yeah.

Alison Werner:

So before we launch into further, we’re going to spoke focus on the Damon Ultima system from Ormco, but I’m curious, what intrigues you about orthodontic treatment today?

Dr. Bicknell:

So you know what’s funny? I’ve been practicing now for 20 years, and I can tell you, and maybe this is just my own opinion, but I am so much more excited about orthodontics now than I was probably at five years into my career. And the reason I say that is when I got out of school, I mean, the technology was there. Liners were just entering the market bracket technology was pretty consistent with it as well. It’s either self ligation, or it’s twin. A lot of my mentors and the people who ran the narrative, in other words, the people who were on the ABO, the people who were the department heads in all the major universities, the people who were writing textbooks, it was a very traditional time, right? And that was great. So wasn’t a lot of advancement that would occur year to year. Now, let’s fast-forward to now. I think that the environment of enhanced technology, and not only the enhanced technology, it’s the manufacturing capabilities that are allowing these products to come to market.

It’s helping us to improve patient care at I think, elevated rates that have never been seen before. And what I mean by that, is we can all dive into our craft. We can all learn how to do amazing ortho with whatever tools are given to us. I do believe that. Now, we may have to work harder to do that. It may cause a little bit more discomfort. It may take longer, it may take more appointments. However, I all think if we all have a commitment to amazing outcomes, we can get there. But what I’m seeing is that the pathway, or the journey to getting to that amazing outcome has become a straighter line, and a shorter line. And that’s with I think the advancements in everything around digital, everything around manufacturing. Because look, if we can invent something but we can’t make it, what’s the point?

And I think that what’s happening now, and whether it’s nanotechnology with cell phones, whether it’s the computer driven kind of AI new thought process on what computing power we need to do things, it’s watering down and trickling down to us. And the fact that somebody can invent something in their mind and build it and have it come to market is what is really helping us. So what makes me excited is that in the last five years, I’ve seen things that I never would’ve imagined. So I can’t even imagine what’s going to happen in the next five or 10.

Alison Werner:

Yeah. That’s a good point. Yeah. I mean, who would’ve thought that 3D printing would be in the practice 20 years ago?

Dr. Bicknell:

Oh yeah. Yeah. And that’s standard, right? In our practice. I mean, it’s not even a thought process to have to send anything out that we could make in house. And you’re not that far away from having potentially that same access to metal 3D printing, right?

Alison Werner:

Yeah.

Dr. Bicknell:

It’s super expensive. But 15 years ago, epoxy 3D stereolithography, the only people that had it, were major industries, right? So there’s just awesome, I mean, it’s cool.

Alison Werner:

Yeah. Well, that’s great. Okay. So let’s talk about brackets specifically. So I’m curious, what stands out to you as you think about how bracket treatment has evolved in the last decade?

Dr. Bicknell:

All right. And I get an opportunity to do a lot of presentations and share kind of ideas. And it’s always funny, I always try to tell people that as I start to speak about something, it’s not that I just remembered it from residency. Typically, when I want to bring out some sort of a concept, I try to research it, figure out where it came from. And part of this ultimate journey for me was to understand, “How revolutionary is it?” And in order to do that, I had to start with, “what was it trying to solve?” In other words, “What problem?” Right? So funny enough, I actually think that from a bracket evolution standpoint, we have been trying to solve the same 100 year problem. And it’s a problem in geometry. It’s not a problem in thinking. It’s not a problem in manufacturing.

The problem was geometry. And if we go all the way back to when Engel created the first edgewise appliance, his edgewise appliance was an 022 by 028 slot that it didn’t have any pre adjustment in it, but what it had was a way to apply forces to a tooth. So you go through 50 years of this evolution, and not a lot happened in that time. So then, you know, get to, let’s say the seventies, and you get to Larry Andrews. Larry Andrews looks at all these models and says, “Okay. There’s a bunch of key points that untreated teeth have. And it turned out to be a pretty key article in your residency called Andrew’s Six Keys to Occlusion. And what he did was he said, “Look, we can maybe use technology to build in some help so that we don’t have to work so hard.”

And that’s really what the gist of it was. So the first pre adjusted appliances came out back then. Now the problem is the geometry was the same. It was still an 022 by 028 slot. And what Larry Andrews saw was that in order for his theory to work, you had to put a wire that was the exact same size into the slot. And practically that doesn’t work. So what that means is if you take a big wire and shove it into a slot that’s the same size, you can’t get it to work. It just doesn’t too much force, it doesn’t go in. So what Larry Andrews did was he decreased the dimension of the wire, and by decreasing the dimension of the wire, you lose control of the tooth. So then Larry Andrews built different prescriptions to end up in a way that depending on what he was trying to solve and what forces he was going to apply, he would get the same end result.

And hence why prescriptions became a big deal in orthodontics over the last 30 or so. And this is what I think everyone’s still trying to solve, and it doesn’t matter what company is trying to solve it, we’ve seen digital companies that have robots that bend wires. We’ve seen newer companies that have 3D printed bracket bases to try to solve the problem. The problem’s the same, it’s geometry.

Now, from what I see, that’s been figured out, and I’m still trying to find ways to poke holes in what Dr. Damon did, and how Ormco has come to market with this. But the bracket technology is based off of the geometric way that the wire fits into the slot of the bracket. And there’s three dimensions and forces, and we’ll get into that I think in a little bit. But I see that this is the first time that a pre-manufactured bracket has been able to apply forces in three dimensions that are predictable and exact. So I think if we look back at this 20, 30 years from now, I think that this is going to be a pivotal time in how the evolution of braces is changed.

Alison Werner:

So as I mentioned, we’re going to focus on the Damon Ultima system. How long have you been using it?

Dr. Bicknell:

So I first saw it in 2017. I was in a meeting and Dr. Damon was finally excited that he solved his problem that he said plagued him for 40 years of practice, and that was being able to control teeth the way that he wanted. So in about 2019, I was invited up to Dr. Damon’s office with a group of maybe 10 or 15 other really amazing clinicians, most of them my mentors, really, in 2019, that goal was to collectively work together to try to validate if this bracket system was going to do what they expected it to do. So the short answer to that question is, I started using it in 2019, but I didn’t fully transition to a full Ultima practice until February of 2021. And that’s probably when I would probably answer that question. So I’ve been a full optimal practice for over two years.

Alison Werner:

Okay. And so for those orthodontists who aren’t familiar with this system, what should they know?

Dr. Bicknell:

So I think that the first thing you should know is that this just isn’t an upgrade to a traditional or a previous version of Damon PSL. So the previous version was the DQ2 bracket, and I think at least at 50% of my answer is going to be that this just isn’t an upgrade. I mean, when you think about what Ormco did is they went back to the drawing board, and they tried to get their engineers and people in the same room to develop a system of bracket wires that are engineered to work together from the ground up to deliver a certain expectation. And that expectation, and I remember hearing this, was that they wanted to create a pure system that would put the teeth where they wanted to go in about a year, but also have a passive system. So to do that, they couldn’t use what they had, so they had to start it from the ground up.

Now, for anyone that’s not even familiar with PSL, I think what people need to know is that it’s basically a system of a wire and a bracket that are absolutely made to work in conjunction with each other. And if we think about that, most of the time we buy a bracket, and then we get a wire, and we just kind of pair what we want. And there’s some protocols that people have, but this was actually designed from the ground up to make sure that the wires and the bracket talk to each other, and that they can express exactly what it is that we want as an orthodontist, so that we can get to the end result of a beautiful finish and a wonderful functional inclusion easier. And the Ultima system was designed to do that. And even from an engineering standpoint, it has. So

Alison Werner:

What are the key features that make Ultima right for you as a clinician?

Dr. Bicknell:

So that’s a great question. So as orthodontists, we’re only allowed to use what products somebody else makes for us. I mean, we can’t go into our basement and make braces. I mean, maybe 70, like 50 years ago people did. But right now, we’re at the mercy of our manufacturers. So I always want to deploy technology that has merit in being proven that it’s precise, it’s reliable. I can actually have access to it without interruption in supply. And I also have to make sure that it fits my value set. My value set truly is to try as hard as I can to give every single person an ultimate experience. And that experience just isn’t fast treatment time. It might be reduced visits, it might be less pain, it might be a simpler approach where our teams can deploy the treatment.

So for me, the ultimate system, it’s that simply because it’s made treatment simpler, it really has it’s used technology, it’s used manufacturing, it’s used engineering, and it’s used just a wonderful group of people to hone this in, to make our journey of beginning treatment to the end of treatment just cleaner, simpler, shorter, and just much nicer.

So that fits. That’s why I use it, because it fits my value set of what I’m trying to do for my patients.

Alison Werner:

And so a part of that not having as many office visits is because that wire and that bracket are made for each other. So you’re doing fewer bends. Correct. As you go along.

Dr. Bicknell:

Yeah, right. So I got in this discussion when I was overseas, and it was cool. I was in Southeast Asia and there was a bunch of orthodontists from India that we were at a beach of all places, and they kind of cornered me, and they were just poking me about the Ultima system. And they’re kept asking, “How does the system move teeth faster? How does this system move teeth faster?” And I’m like, “It doesn’t move teeth faster. I go, that’s biology. I go, what it does is it eliminates the times where you’re not moving teeth. And it does that by allowing us to apply forces in all three dimensions in a certain order.” So we can do the X and the Y, or in other words, first and second order, and then we can build into the third, which is torque. But by having a system that actually delivers the force in all three planes, and then once it delivers that force, it turns back passive.

What that looks like on a velocity curve is that we have less, “Start, stop, start, stop, start, stop.” It’s much more like the tortoise and the hair analogy. If you just apply nice even forces to teeth, and you do that in a way that is thoughtful per patient, you can eliminate even the times where these systems aren’t working. And if you can eliminate those, then you eliminate the number of visits and you shorten the treatment time drastically.

Alison Werner:

Okay. Okay. So what impact has Ultima had on your cases? Have you seen a change in how the cases are finishing?

Dr. Bicknell:

Yes. Now one thing to remember, and this is what I kind of alluded to before, is that we all work to get amazing case finishes, and we all work to get amazing case finishes at the highest rate of reproducibility. In other words, let’s say we’re looking at 100 cases, how many of those hundred cases finished to a level that we love? And there’s very few orthodontists that have a 100%, right? So is it 50, 60, 70, or 80 or 90? Now, the systems that we’ve always deployed in our practice were to try to figure out ways to get that number as high as possible. It requires a lot of work, more avoid more appointments, more physical effort of bending. And the reason for that was because there’s play between the wire and the bracket. In all systems, right? Even active systems have some sense of that because the thought is that the active system or a clip is pushing a wire into the base of the bracket.

And if that assumption is not valid, then that doesn’t always happen. So you’ve got all of these systems and things that are trying to solve that problem. What I’m learning now is that because I’m actually able to apply force and three dimensions and I can get the tooth where I want it, my case finishes are looking so much better with very little bending. And believe me, I bent a lot of wire previously, I mean a lot. And I’ve actually measured. I measured 100 cases, and I looked at how many bends I had per wire versus how many bends I have per wire and Ultima. And I mean, we have a lot less, about nine 98% less bending in our practice. And our case finishes, I mean, I’ve never been more proud of what we’re putting out as a product, meaning straight teeth and beautiful smile.

Alison Werner:

So when it comes to how the system has impacted practice productivity, what would you say to that?

Dr. Bicknell:

So productivity is interesting. So I’ve always been processing systems driven. If anyone’s ever heard me lecture, I try to, if I see a problem occurring, I don’t just solve the problem, I try to trace it back to figure out, “Why did the problem actually exist in the first place?” So we’ve always been super methodical about processes in our practice and systems to try to engineer out, if you will, outcomes that could be avoided just by catching things earlier. So from a productivity standpoint, Ultima has been amazing for us, because by eliminating a lot of the, let’s say, play in the wire bracket assembly, there’s less room, if you will, for things to go sideways. And there’s less bending, there’s less visits. And what I find with productivity is that when you can shorten the number of visits and you can shorten the overall treatment times, productivity goes up.

Now, it doesn’t mean that we start more cases because we’re using a bracket, but what it does do is allows us to treat each individual case in a more compressed timeline. And what that does is that opens up availability to either have more capacity, or to give more attention to your cases. Hence, having more attention and less volume, it’s like a dog chasing its tail. You know, end up becoming a little bit less stressed throughout the day. You can give more time to your patients, you give more time to your patients, they like you more, they send more patients. So our productivity has been drastically changed by incorporating Ultima. And if we have a little bit of time, I can tell you exactly what that means. But from a number standpoint, we just did this metric, it’s pretty crazy. I look at the total number of starts and then I look at the total number of active patients.

It’s just a really simple way of looking at, “How long is your treatment time truly taking?” And I have a seasoned practice, so it’s not like I’m growing at 30% per year. So if I’m growing, let’s say five or 10% per year, I know roughly the starts that I have are pretty consistent, which means if I look at the total number of active patients, then I can do some math and figure out what my average treatment time is. Well, we started Damon Ultima two years ago, and we are now two years into this journey. My number of active patients has dropped almost 35%, while my total number of starts is increased by 10% each year. The only way that happens is when you shrink treatment time.

Then we looked at the total number of appointments, and we’re seeing that the total number of adjustment appointments needed has shrunk by 30% over the last year. Which if you’re a numbers driven person, the only way that happens is if you’re treating patients shorter and with less appointments. And on top of that, I’ve never, like I said, I’ve never been happier with the results that are coming out of my practice from a quality standpoint. So I feel that we’re getting our qualities up and our efficiencies are up. And from our productivity standpoint, it’s leading so much capacity, and our days are great. They’re not stressed. We’re definitely not the practice that is sweating at the end of the day, and yet it’s fantastic. I mean, it’s so much fun.

Alison Werner:

Yeah. Well, it sounds like I was going to ask, what kind of efficiencies have your staff experienced with this system? So it sounds like it’s making their day a bit easier, too.

Dr. Bicknell:

All right. Well, you just answered my question. Yeah. No. You answered for me. No, I remember when we started. Right. Merging two systems is always interesting when you’re trying to buy your team into what it is that you want to do as a doctor that you need buy-in. I mean, we have 27 employees, so two locations, 27 employees. We have about 14 clinical specialists. I always refer to my team as not assistants, but clinical specialists, because I try to tell them in a room, they are the expert. They really are. It doesn’t matter if my patient’s dad is a CEO of a bank in that small bubble. If I’m not there, my clinical specialist is the expert. They know more about ortho than anyone else in the room. So we empower our team to understand treatments. We empower our team to make decisions.

We have clinical meetings every morning where we discuss cases, we talk about mechanics, we talk about even first, second, third order, like tooth movements. So I really want my team to understand what it is that they’re doing. When we first brought on Ultima, they were like, “Okay. Fine. Something new.” There were a couple different wires, and it was a little confusing just because we had a few different protocols, but we only have about 35 cases left of DQ2, and we’ve got the rest of them in Ultima. And I can tell you that my team, I’ve had many of them have been with me for probably 10 years, say that if they didn’t have Ultima, they probably would have not had stayed in orthodontics. As orthodontists, and we don’t realize this, and in an age of employment being a really difficult problem for small businesses to accommodate, if you really look at this idea of, “Why are people leaving their jobs?” They’re leaving their jobs because they don’t feel fulfilled, they don’t feel like they’re good at it.

And I always joked as an orthodontist is that we put our teams in positions to fail. From an orthodontic standpoint, if I’m busy and I’m running an afternoon where I have a lot to do, and I’m a little bit behind, and let’s say I bend a wire and maybe I bend that wire a little bit too much because the parent’s staring at me and they know that I’m a little bit overtreatment time, so I’m trying to maybe push the envelope and then I’m busy. So I put the wire on the table, and I have one of my clinical team members put that wire in. Well, when they put that wire in and they close the door, they tie it in, it creates pressure and pain for the child. So the child leaves, then the child goes in the car and sometimes can cry to their parent.

The parent becomes protective and says, “You know what? So-and-so just worked on my daughter.” Let’s say, “April.” I don’t have any Aprils that work for me. “April just worked on my daughter. My daughter’s crying. I never want April to touch my daughter again.” And every orthodontist has had this call. So then we flag the chart and we put, “April’s not allowed to work on this patient.” April finds out about it, and then April feels that she’s not good at her job. So then eventually April tells herself she’s not good, and then she’s like, doesn’t have passion, and she quits and goes and goes to work for a florist or something. Right? Well, what I’ve found with Ultima is that I’m not putting my team in positions anymore where they don’t feel like they’re an expert. I mean, Ultima makes it so that we have four beautiful wire changes.

They’re all equally significant from a standpoint of force. We’re not bending wire. And when you don’t bend wire, and it’s a simple, easy protocol, your team knows exactly what to do. They’re not waiting for me to tell them what to do. They already know. They’re like, “Okay. It’s going from this wire to this wire, this wire to this wire. Oh. Now we’re going to take photos. Dr. Nell’s going to look to see if anything needs to be moved around. Okay.” And it’s becoming so much easier for our junior team members to become experts. The last thing I’ll kind of highlight on this is we had a recent hire, and she’s phenomenal. I mean, phenomenal. She’s young, she’s like 20 maybe. I don’t know, maybe she’s 22, 24 years. I don’t know. I don’t know how old she is, but I should, but I don’t. Anyway, what’s amazing is she is up to speed.

And I used to always tell people, how long does it take for you to become a very clinically astute orthodontic assistant or specialist? And most people would say, it took two to four years. This girl’s been working with me for nine months. And I go, “What’d you do before?” And I think she worked at a jump zone. It was like a trampoline place for kids. She had no dental experience. And within the course of nine months, she is one of the strongest clinical specialists I’ve ever seen. And I asked her, why does she think that that was the case? And she’s like, “Well, this stuff is really straightforward and simple. She goes, and it allows me to get really good at it, and now I feel like I have a career.” And that to me is why we have assembled a team and we’re not facing the turnover problem that I think a lot of other people are.

Alison Werner:

That’s really fascinating how the product plays into the job satisfaction. I think that’s the best example I’ve heard of that. So thank you.

Dr. Bicknell:

Oh. And not only that, totally unexpected too. I mean, from a selfish standpoint, I was like, “Oh. I’m going to be a better orthodontist then I’m going to be able to finish cases faster.” And it wasn’t until utilizing this full on for two years that I realized what it’s actually done for our deployment of our technology. It’s been pretty amazing here.

Alison Werner:

Oh. Absolutely. Okay. So what stands out to you when you think about Ormco as a partner?

Dr. Bicknell:

What, I actually had this conversation with the education department back in 2015, and I said that, “From a standpoint of somebody who utilizes products as a way of delivering care to my patients, I need a trusted partner that is going to listen to what it is that I’m trying to do. And not that they’re going to steer their ship in my direction. I mean, I’m not that centric, but I want a partner that’s going to listen to our profession. I want a partner that I think is a good steward of our profession.” Now, we all know that we live in a capitalistic society, which means that there’s reward for innovation. So if a company comes up with something that is innovative, then they definitely have a right to charge and profit from that, because it helps drive innovation. It’s okay. We all do the same thing as small business owners.

If we didn’t have a reward for our hard work, then there wouldn’t be this drive sometimes to continue to improve and continue to become efficient, because that is a reward, whether it’s a reward in quality, whether it’s reward in less effort, whether it’s reward in financial, whether it’s a reward in fulfilling our value set, that has to happen. So when I think of a partner, I think of a company that is on the leading innovation, I think of somebody who is going to help protect and drive our profession forward. And I think of a company that is continuing to invest dollars in multiple areas of the orthodontic profession. And right now, the only company that I see doing that on all levels, whether it’s aligners, whether it’s braces, whether it’s wires, whether it’s scanners, whether it’s imaging, whether it’s vision, whether it’s other areas of dentistry, is [inaudible 00:30:40] and Envista. So that’s one of the things that I like about it, and I know that as of now, they’re a prime partner for me.

Alison Werner:

Great. Okay. So when you’re assessing a new bracket system, what are the key considerations you keep in mind?

Dr. Bicknell:

Probably execution. And I say this, and I said this before, if something comes out better than what I’m using right now, then I’ll probably use that, right? And I said that, and I’ve lived by that. I mean, I’ve tried other bracket technologies, and when I evaluate something, unless it performs the same or better, I mean, there’s not really a reason to utilize it for any reason for me. This was a big issue back in 20 15 16 when I just was not super happy with what was happening in my clinic, and I just felt that the bracket that I was using, it just wasn’t delivering the results that I wanted it to. I was working really hard. So I explored other options, and that’s when I kind of saw what the ultimate system in theory was going to do.

And I waited around a couple years for it to come out, and I’m glad I did. When I think about what it is I want it to do, and I always joke about this, I say that, “Things should work the way that we plan them too.” So if I have a bracket system and in my mind it should work a certain way, then if it doesn’t, then I either need to learn more or change my perspective. And if my perspective or thinking is clear, then it’s just not the right product. And that’s one of the things that’s been my motivation to get out there and have fun talking about this new change in what I think is our profession from a fixed bracket standpoint, is that for the first time in my 20 years, I feel that I have something that works the way that it should.

There really are very few, if any, parts of this that I have to accept as a bad thing that goes along with a bunch of good things. And I think in PSL, before you did. The reason that a lot of people didn’t like PSL was that it was so passive at the end the teeth kind of were hard to control. So everyone was like, “Well, why can’t finish in PSL?” So then there’s ASL, and there’s all these other systems that come out, but with the Ultima system, it’s passive until there’s a couple placed on either X, Y, and Z access or first, second, and third order control.

And once that couple, which is basically a force that moves, a tooth is exercised, the system becomes passive again. Really, I always joke about the Ultima system that, “You put the braces on, they’re active until they’re not. And when they’re not, the teeth are in the right spot, and then you take braces off.” And that’s really how it works. And it’s really that simple. So for me, when I get a systems that work that way, then I really deploy that type of technology.

Alison Werner:

Okay. So final question. What excites you about the future of orthodontics?

Dr. Bicknell:

Oh. Like everything. Seriously. I mean, honestly, if this was 2015 or 16, it’s frustrating. I mean, it just was like, I mean, it’s fine. I love my job. I love my patience. I love what we get to do every day. I love the community of people. I mean, I’m blessed to be an orthodontist, literally. I mean, I always joked, except for maybe a motion picture actor that could play anybody or an astronaut that actually gets to go to the moon. There’s nothing else I’d want to do. I got so lucky to find my way into orthodontics that it fits every part of my brain. But what I know now is I’m so blessed to have access to what’s happening now in orthodontics in the middle of my career and not at the end of it. Because I think if I was at the end of my career and I saw all these cool things coming, I’d just be a little bit, “Eh. I wish I would’ve had that.” Right?

And yeah, the fact that the next 5, 10, 15 years are so unknown, yet we know what’s going to happen. I mean, there’s going to be some amazing things that come on board, and I literally can’t wait to see them. And some of the things that I’m even seeing in the pipeline are amazing. I mean, think about when we think about disruptive technologies, we think of things that have to change the rules, and the people that say the rules can’t be changed are wrong. Because every single rule, as we go through, we look at science books, right? Science books, aside from Newton and physics, science books have always had a hypothesis and what they thought was true, and then sometimes it’s proven to be maybe a little different than what you thought. And that’s the whole idea of growth. And if we sit back on our heels and we say, “Well, nothing else is going to be invented, nothing else is going to be improved”, then we’re doomed as a society.

So the fact that we have all this cool stuff happening, of course it makes it a little bit sketchy. Some people are doomsday like, “Oh my gosh, patients are going to be able to scan their teeth with an iPhone and get trays.” Well, that’s cool because at the end of the day, there’s 7 billion people on the earth. And right now there’s only 1% of that population has access to orthodontic care. How cool is it that we can have technologies that are driven to make treatments simpler, make them shorter, we can deploy them to more people, even if the overall cost basis goes down, more people gets to take advantage of the cool stuff that we get to do. So what excites me is the fact that more people have access to this care, and it’s just a ton of fun as a provider.

Alison Werner:

Yeah. Great. Thank you so much for joining me and sharing your insight and your experience with this system, and also just your practice and your career. I really appreciate it.

Dr. Bicknell:

Yeah. No problem. This is fun. I’m all pumped up. And it’s a Friday.

Alison Werner:

Yeah. Exactly. It’s Friday.

Dr. Bicknell:

Yeah. Yeah. Yes. No. Obviously, if you can’t tell, I love all things ortho. I mean, it’s a lot of fun. So yeah. It’s just a blessing. I mean, for all of us to get to, for all of us that are even remotely in the realm of orthodontics, it’s such an amazing thing that we get to learn, study, and do for not just our teams, but our families, our patients, and our whole community. So this is my social network. It’s my friends, it’s my colleagues, peers, mentors, and students. So it’s a blast.

Alison Werner:

Great. Thank you so much. And to our listeners, be sure to subscribe to the MEDQOR Podcast Network to keep up with the latest Orthodontic Products podcast and to turn to orthodontic products online.com to keep up with the latest industry news. Until next time, take care.