New consumer research validates the importance of orthodontists while also indicating the need to improve patient education

Dr. Jeff Summers delves into a study of patient perceptions that affect choices of orthodontic practices and treatment.

Jeff Summers, DMD, discusses patient perceptions that can impact orthodontic practices

Note about the survey: Commissioned by Ormco, the national, online survey of 1,011 U.S. consumers, targeting adults (18-plus years) and parents, was conducted by Propeller Insights between Sept. 15 – Sept. 17, 2019. All participants self-identified as having purchased teeth-straightening products or services in the past 4 years or are considering purchasing teeth-straightening products or services within the next 2 years. Responses have a maximum margin sampling error of +/- 3 percentage points with a 95% level of confidence.

While I take comfort in some of the findings of a recent national consumer study conducted by Ormco on the state of orthodontics from a consumer perspective, the results also underscore for me the need for orthodontists to be ever-committed to patient education, patient experience, and advocacy for our profession.

A smile is the No. 1 trait of a first impression

In orthodontists’ favor, a smile ranked as the No. 1 physical trait of a first impression among adults and parents who rated it significantly higher than eyes, height, weight, hair, skin, or body type. In fact, when asked to prioritize physical issues parents and adults would fix, if an issue for them or their children, both adults and parents ranked straightening teeth as their No. 1 priority above addressing weight, skin, hair, fixing their nose, or swapping contacts for glasses. All of this validates the important role orthodontists have in not only functionally addressing oral health and proper bite and alignment, but also in the esthetic and emotional role we play in perfecting beautiful smiles. And we shouldn’t shy away from or be ashamed of that. We are changing lives.

Investing in a smile is perceived to pay many dividends

Correlating with the importance parents place on having a great smile, 9 out of 10 parents ranked teeth straightening as the No. 1 financial investment they can make in their children’s long-term success and happiness. This ranks above tutors, sports programs, music lessons, weight loss, or acne/skin treatments. Adults also rated it No. 1 over all other options, including cosmetic surgery.

Maybe all of this desire for a great smile — and its lifelong benefits — is rooted in the fact tPatient perceptionshat fewer than 1 in 2 (46%) adults feel confident with their own smile/teeth. At a minimum, everyone deserves a welcoming smile he/she loves.

According to the study, parents who seek orthodontic treatment for their children do it almost equally to boost confidence (63%) as for health reasons (60%). But it’s notable that approximately 2 in 5 parents do it because they believe it will help their child be more successful in life, improve attractiveness, or protect their child from potential bullying. Adults seek orthodontic treatment to boost confidence (59%), attractiveness (55%), health reasons (45%), reduce judgment from others (24%), and help with career success (20%). I am sure if you are like me, by the end of each patient’s treatment, you see a new sense of confidence that radiates, enough so that we can see it through a patient’s eyes, not just a new smile. But it’s equally gratifying if we may also help the elimination of needless bullying or unfair judgment — in a classroom or in the workplace.

But it’s not all good news

Despite the significance attributed to orthodontic treatment in both the cost and lifelong importance, the study reports that more than two-thirds of treatment seekers do fewer than 3 hours of research to make treatment decisions for themselves or their children. In fact, more than 20% of parents and almost 40% of adults did less than 1 hour of research or no research at all.

At the same time that people are not searching for the facts or learning about the newest treatment methods, they are being bombarded with marketing messages directly from aligner manufacturers promising great results at a fraction of the cost and time of traditional braces — all without the need for a doctor. As a result, 7 in 10 parents or adults cited they would consider an aligner sold directly by a manufacturer that did not involve any doctor visits. Yes, you read that startling number right: 7 in 10. We should all sit up straight and be nervous by that statistic.

Equally concerning is that two-thirds of those polled do not find today’s treatment options straightforward, customized, or consumer friendly. We haven’t done as good of a job of getting the word out as well as the direct-to-consumer (DTC) manufacturers have. We have work to do.

We have a responsibility to continually advance our own knowledge with continuing education, for sure, to be on top of the latest science, technology, and products for efficient, effective treatment with beautiful outcomes. But we need to share our knowledge with the public at large, not just prospective patients. Patients are hearing about DTC aligners, clear aligners through a doctor, more progressive braces like the Damon self-ligation system, lingual braces, advanced ceramic esthetic options, claims of fewer or no doctor visits, promises of reduced treatment time, and statements that extractions or palatal expanders are often not necessary. How are consumers to know what’s right for them, or what is fact versus myth?

The onus lies on us to help our patients know their options and the pros/cons based on their treatment needs and goals. It’s also up to us to share with prospective patients and the public why our training and experience is key to the movement of teeth, bones, and jaws. We can also refer them to for a wealth of information.

Beautiful smiles are more than straight teeth

Beyond becoming vocal advocates for our profession, we also need to help the public understand the variables that go into making a beautiful, natural-looking smile. We all know it is a lot more than just straight teeth. We know straight teeth can create a flat, dull appearance. It is about teaching people what a smile arc is, and how good treatment aligns the top teeth with the natural curve of the bottom lip for a full, natural smile. We need to show patients the difference between a narrow-arch smile versus a broad-arch smile, and how a broad-arch smile eliminates un-desirable shadows in the buccal corridor, not to mention creates a better substructure for a more youthful appearance and more graceful aging. The study reports two-thirds of adults prefer a broad-arch smile that shows more teeth than a narrow-arch smile when shown images of the two. In fact, 77% of parents and 72% of adults preferred a broad-arch smile with more teeth showing over their or their child’s posttreatment smile when shown a picture of a broad smile.

We also need to show our value in helping our patients achieve the best smile possible by explaining that beauty is in the details beyond desired straight teeth: gingival contouring, reshaping teeth, color correcting, and eliminating excessive and unsightly gum tissue in a smile, if that’s a concern.

A picture is more than a 1,000 words

With each consultation, I begin with understanding what the patient most wants treatment to fix. Once I know what he/she doesn’t like, I can customize and personalize our discussion and treatment recommendations around functional and esthetic goals that matter most to the patient. The best way to educate and also help the patient visualize his/her own transformation is by showing professional before-and-after photos of similar cases that yielded beautiful results. I keep in mind that people want to see people like them, so I fill my office with professional images of remarkable smiles we have created with everyday people of all different ethnic backgrounds. People want to see themselves in your patient mix. Attainable beauty. Not everyone is a supermodel. But everyone deserves a big, beautiful, confidence-infused smile that lights up a room.

Additionally, we can use these pictures to educate patients on the other esthetic benefits of their orthodontic treatment in addition to their chief concern. The Ormco study (noted on page 32) showed little public understanding that orthodontic treatment can improve facial symmetry and facial profiles, enhance appearance of the lips, reduce noticeable creasing on the sides of the mouth and exposed gum tissue, create a more youthful appearance as we bring down teeth that no longer show due to lost lip elasticity, and so much more. Again well-executed photography of similar patients’ before-and-after images go a long way in patient education.

I have never been prouder to be an orthodontist. Every day my patients tell me and my team we have been a game changer. I hope all of you feel this way, too. Let’s make sure we use every opportunity to pass on our knowledge, and capture and share our patient transformations. There is no better advocate than a thrilled patient or parent who shares the video and photos you have taken and provided to them or posted to your social media channels with their consent. Let our happy patients get the good word out of the significant work we do. Let’s be advocates for our profession and educators of ourselves and the public on the latest treatment modalities and facts. Our future is depending on it.

Patient perceptions and orthodontist insights are involved in this article regarding white spot lesions. Read the article here.

Jeff Summers, DMD, is currently a private-practicing orthodontist, educator, lecturer, and industry key opinion leader, based in Greenville, South Carolina. He has degrees from Clemson University, the Medical University of South Carolina, and the Medical College of Georgia.

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