The Golden Age of Orthodontics – Decline and Aftermath

A History of the Business of Orthodontics • Norman Wahl, DDS, MS, MA
First Edition Design Publishing Inc., Sarasota, Florida

As orthodontics’ most eminent and thorough historian, Dr. Norman Wahl has assembled material from his other historical documents to offer readers the most complete body of orthodontic information ever presented. The amount of research and preparation contained in this small paperback tome will astonish readers.

Dr. Wahl considers the time from the end of WW II to about 1970 as a golden age for orthodontists. The baby boomers coincided with the public’s increased optional incomes to provide orthodontists with a huge rush of patients heretofore unknown or experienced. Older friends have confided that a 6-month wait to even see a new patient was not unusual during this time. Nevertheless, the supply of orthodontists began to outrun the demand for their services, which occurred with the end of the baby boom. Additionally, “the pill,” which diminished the number of births, and bonded appliances, which made it easier for others to apply orthodontic therapy, made that happy, almost delirious time for orthodontists come to a halt.

Dr. Wahl uses Part One of the book to describe important events in the early history of orthodontics such as those from the late 19th century to 1930 and to also describe the development during the Depression of the 1930s to 1950. Dr. Wahl deftly discusses all of the factors that contributed to the decline such as prepaid dentistry, lawsuits, diminished birthrates, legislation, consumerism, group practices, technology, graduate glut, intradental relations, super clinics, and professional complacency.

Part Two brings the reader into the 21st century where Dr. Wahl describes patient supply, GP orthodontics, corporate orthodontics, MSOs, and government agencies such as OSHA, HIPAA, ACA, truth in lending, electronic health records, and continuing education requirements. A further chapter defines patient relations, economic cycles, consumerism, student debt, and interdental relations. In a successful endeavor to bring the book completely up-to-date, Dr. Wahl describes developments such as TADs, customized appliances, aligners, and 3D study models, along with do-it-yourself aligners.

Chapter XIII devotes its contents to practice management issues such as marketing, orthodontics as a business, auxiliaries, pricing/fees, and practice transitions. Chapter XIV deals with risk management subjects such as payment disputes, adult treatments, and defensive practice techniques. The final two chapters of Part Two deal with orthodontic education and trends plus a summation of the second part.

Dr. Wahl has collected the most extensive bibliography on orthodontic matters this reviewer has ever seen or probably will ever see. It boggles the mind to imagine all of the research, reading, and documenting that went into this book, but if you want to know the who, what, when, where, and how of orthodontic events, this is your book. Anyone with even the slightest interest in orthodontics needs to have this book, and orthodontic departments will do their residents a great favor by including this publication in their required libraries.

Review by Dr. Larry White.