by Christopher Piehler

Christopher Piehler

Some words mean such different things to different people that they are in danger of losing their meaning altogether. A great example of this is “success” (and, come to think of it, “great”). Given the narrow context of orthodontic treatment, though, is it possible to reach a consensus on the definition of success?

When I had braces back in the ’80s, my orthodontist’s definition of success was moving my teeth where he wanted them. He accomplished this, but as I remember it, reatment time and my comfort were not major factors in his decision-making. Perfecting the “social six” was not part of the treatment plan: I had a peg lateral that sat there looking tiny
… until my second round of orthodontics.

When I had Invisalign a few years ago, the success of the treatment was measured not only by the final occlusion but by the total treatment time and by how I looked and felt during treatment. One of the goals the second time around was making space to fit a veneer on that peg lateral.

Can either (or both) of these treatments be deemed a success? The first gave me a functioning occlusion that lasted 20 years—but that ultimately needed to be “refreshed,” as the plastic surgeons say. The second fixed the major aesthetic flaw, but even though I wear my retainers every night, there are minor tweaks that I wouldn’t mind seeing.

Which brings us to a point that Nona Naghavi, DDS, and Laurance Jerrold, DDS, JD, make in their Word of Mouth article. Sometimes the orthodontist and the patient have different definitions of success. To help bridge this gap, their article ends with a request for your ideas to add to an “outcomes-assessment form” for patients. I hope you will take this opportunity to help define success in your specialty.

Of course, as orthodontists, you can define success with each new patient. What you say during that first appointment can determine a patient’s satisfaction almost as much as what you do during months of treatment. Some orthodontists chose to limit expectations, but I know one who offers a “lifetime guarantee” to patients who wear their retainers as prescribed.

So tell me, what’s your definition of success? And what do you do to define it clearly for your patients?

Christopher Piehler