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Multiple Phases. Why?

December 20th, 2018

One question that I'm asked and read online frequently is, “why do orthodontists recommend braces for children who are young enough that they will likely need braces again when they are older?”.

This is a great question!

There are several reasons why you would treat a younger patient: to avoid problems getting worse, reduce tooth wear, and reduce the risk of significant dental injury.

The most urgent early treatment problem is caused by an upper jaw that is too narrow (unilateral crossbite with functional shift) and the lower jaw slides off center when a patient bites down. This shifting actually warps the lower jaw growth, loads the jaw joints unevenly, creates muscle spasms, tooth wear, and potentially causes joint damage. We never want to wait and watch a bite problem that causes growth to become more and more asymmetrical.

Dr. Aron Dellinger - Posterior crossbite before Phase I treatment.

Dr. Aron Dellinger - Posterior crossbite resolved after Phase I treatment.

The second problem is spacing/crowding. If there is not enough room for teeth to develop and come in normally, you may eventually need to extract permanent teeth to provide a path for others to come in. More teeth are usually better than less, so if it is possible to create space by expanding and growing the jaw then you could save teeth from being extracted.

Dr. Aron Dellinger - Before Phase I Treatment

Dr. Aron Dellinger - After Phase I Treatment

Third is traumatic function. If the permanent teeth are hitting each other in a destructive manner, you want to move them so they don't fully destroy each other. This traumatic function can occur when only a few permanent teeth have come in, and it may be a long while before the rest of the permanent teeth arrive. During that time, it is possible to ruin the enamel and significantly reduce the life span of the involved teeth. Also, the front teeth come in first, so you're ruining the front teeth!

Dr. Aron Dellinger - Traumatic Function Before Phase I treatment.

Dr. Aron Dellinger - Traumatic Function after Phase I treatment.

There are several other reasons you would treat a young patient knowing that they will need another phase of treatment when the rest of the permanent teeth arrive, but most of them fit into those three categories (crossbite, spacing and traumatic function). The absolute best way to know if your child needs early treatment is to contact our office to schedule a complimentary consultation.

Dr. Gene - Our Founder

November 20th, 2018

Dr. Gene is a great father, full of truth and wisdom that he wants to share with any who would care to listen. His love of food made meal time a special part of our lives. We would sit for long dinners enjoying all kinds of amazing foods, but more interesting for me was the table talk. The subject could meander from hard work and scholastic discipline, to how to avoid getting into trouble by choosing your friends and activities carefully.  He would share time and time again that if you love what you do for a living then you never have to work a day in your life. He loves orthodontics.

Orthodontic Specialty Services | Dr. Aron Dellinger

Dr. Gene's father was a carpenter, factory foreman and a jack of all trades. His mother a retail sales clerk. He came from humble means and was the first in his family to attend university. Gene always had a drive to achieve academically and had a great work ethic, which he learned from his parents. His parents moved from Decatur to Fort Wayne so that he would have access to education and the possibility of attending Indiana University.

Orthodontic Specialty Services | Dr. Aron Dellinger

He graduated from Fort Wayne’s North Side High School and spent his first two years at “the extension” in Fort Wayne. He then transferred to IU Bloomington his junior year. (At that time Bloomington was the only place one could complete an undergrad degree.) He spent his summers working on a civil engineering crew, learned quite a bit about engineering, and enjoyed the practical application of his mathematical education.

Orthodontic Specialty Services | Dr. Aron Dellinger

While in Bloomington, he lived in a house off campus that cost him $1 per day. Included was his breakfast and laundry service in exchange for lawn mowing and snow shoveling.   He also worked as a waiter at the Delta Gamma House where he could have his lunch and dinner as part of the work arrangement. He also got special meals in the winter time from the cooks at Delta Gamma in exchange for warming up their cars and scraping off the snow/ice from their windows.

Orthodontic Specialty Services | Dr. Aron Dellinger

During his time at IU Bloomington, Gene began courting Rosalie Hasewinkle, the daughter of a Fort Wayne physician. She and Gene were friends in high school and grew closer as they fell in love at IU. One Semester Rosalie noticed that Gene would go on study dates with her but never brought any books with him. She asked how he managed to study without any books, and his response was that he had enough money for tuition and his room/board but there wasn’t anything left for books. She proceeded to purchase his books for him that semester and famously proclaimed for the rest of her life that it was one of the best investments she ever made!

Orthodontic Specialty Services | Dr. Aron Dellinger

Gene graduated from IU Bloomington, and went on to IU School of Dentistry for his DDS, and continued there ultimately earning his MSD in Orthodontics.

Orthodontic Specialty Services | Dr. Aron Dellinger

Dr. Gene’s work ethic and love of orthodontics helped him become incredibly successful, but it wasn’t easy for him. He moved back to Fort Wayne when he finished school to set up practice, and he learned quickly that there were several other orthodontists who had already established relationships with the referring dentists. It was tough getting started, but he built friendships with dentists, treated the tough cases well, and he made sure his patients had a great experience. He worked long hours, and became one of the first ABO certified orthodontists in the area. After about 5 years the practice finally broke even.  A few years later it was obvious that he had established one of the busiest orthodontic practices around! During his career he won the Milo Hellman Award for original research and continued to write several benchmark journal articles. He spent nearly 40 years in private practice, also lecturing, and teaching worldwide.

During this time, Gene and Rosalie traveled the world together, celebrating life with friends and family. They loved to host meals in their home, and often were referred to as the best restaurant in Fort Wayne. They had two sons Eric and Aron - both orthodontists. Sadly, Rosalie passed away March 30, 2007 after a long-fought battle with breast cancer.

Gene is now fully retired from private practice. His family and business legacy are a testimony of his commitment to excellence and hard work!  Gene still loves to host meals in his home, spending time with friends, sharing great stories, and fine wines. We are all so very thankful for Dr. Gene!


Team Meetings

September 19th, 2018

All-team meetings are a huge part of the culture at OSS. Every 6 months we take time to meet as a whole team. With two office locations and differing work schedules it is not uncommon for some team members to have no face to face interaction with several other team members. We value communication as our number one team principle, so it is important for everyone to communicate on a regular basis.

All-team meetings allow our collective talent and knowledge to come together. We share ideas and challenges which provides a broader perspective to problem solving and greater unity as changes are implemented. Sharing information across teams, as well as up and down the chain of command, is essential to making sure good ideas are implemented. This unrestricted communication is also important for identifying problems that need to be addressed.

Our culture functions much like a family. Caring/nurturing parents, responsible older siblings, and respect for one another set the stage for healthy family communication. Managers and team leaders are selected because they work well with their respective teams, and have the ability to identify and encourage the best in others around them. Teams are built based on the skill sets of the individual members. Special projects and specific duties are assigned to team members based on sub-skills and interests of individual team members.

Below is the agenda for our most recent team meeting:

8:00                      All-team and small group photos at Parkview.

9:00                      Return to OSS for individual photos in the lobby.

10:00 – 11:00     Presentation.

11:00 – Noon     OSHA.

After OSHA teams will get details about: “Inspire a Genuine Smile Projects”.

Noon – 4:30      Groups discuss Genuine Smile Project ideas, lunch & offsite activity.

4:30                     Return to OSS.

Offsite activities are often intended to be a surprise and a reward for team members.  At the last all-team meeting we had a team lunch and then went for a trolley ride visiting some shops around town.

“Inspire a Genuine Smile” projects are designed to get our team members collaborating and serving others. This time we broke into several groups of 5 or 6 people, each group was given $50 cash and instructed to “Inspire a Genuine Smile”.

The groups all had unique ways of making that happen. One group bought three dozen cookies from a local bake shop and took them downtown with a sign that said “smile for a cookie”. They took pictures and made a short video of all sorts of people smiling for a cookie; homeless folks, police officers, business executives, and downtown shoppers all smiled for cookies!

One of the teams went to an animal shelter and brought in items they needed for the cats and dogs. They stayed and played with some kittens, and shared a smile with the volunteers at the shelter.

Another team took a box of delicious treats to a firehouse and shared it with the firefighters. One group went to a Mexican restaurant and asked the manager which waitress could use some help. They got her table, enjoyed afternoon snacks, and then gave her an envelope with the $50 tip inside. She cried, then smiled and hugged them!

Another group went to the Dollar Tree, purchased a whole grocery cart full of household items, and then delivered them to a facility that helps displaced families get back on their feet. The volunteers at the facility were amazing! They took a beautiful smiling group photo and shared stories with the team.

The last group went to Erin's House, a facility for grieving children, and purchased items from their wishlist. They delivered craft items, coloring books, stickers, markers and picture frames.

All of the teams returned to the office and shared pictures and stories of the smiles that were inspired by each group that day!

I say this often and it remains so true...I am so blessed to work with this amazing group of people!

What About Aligners?

June 6th, 2018

Clear aligners, Invisalign… What exactly is it and how does it work?

I should preface this blog post with… aligners are not for everyone!! Many factors play into why braces or other devices may be substantially more effective for a specific patient.

Choosing the correct orthodontic appliance for a specific patient is critical to achieving the best results possible.

How do clear aligners move the teeth?

Dr. Aron Dellinger - Orthodontic Specialty Services | Clear Aligners

Clear aligners fit over the teeth, snapping over their convexities. A series of aligners is required to move teeth orthodontically. Each aligner has a slight change in its shape as compared to the previous one. This small change causes the aligner to flex a tiny amount as it goes over the teeth. That slight flex puts pressure on the teeth that will, over about two to three weeks of full time wear, move an individual tooth about .25mm.

Computer software and a 3D scan of the dental arches are used to specify where each individual tooth should move to create a “set-up” of the desired finished outcome. This set-up can be evaluated to determine which type of tooth movement is required to get the teeth from their starting positions to the projected outcome. Calculating the movement in millimeters and degrees provides the necessary data to determine the number of aligners required in the series to complete the case. More complex cases with lots of change in tooth position will require more aligners in the series, and thus treatment will take longer to complete.

Dr. Aron Dellinger - Orthodontic Specialty Services | Clear Aligners

Are there different types clear of aligners?

Yes…Invisalign (a clear aligner) is a product just like Kleenex (a facial tissue). There are several companies that produce aligners for tooth movement. Invisalign simply has such excellent brand recognition, very few people distinguish between the name brand and the actual device.

Invisalign is a clear aligner product marketed, by Align Technologies, a multi-billion dollar a year international company. Align Technologies was the first company to deliver a system of clear aligners that could be used for comprehensive tooth movement. I was very early on the scene with Invisalign and became certified in the technique 20 years ago.

In every market there are advantages and disadvantages to choosing a specific brand of product. Invisalign has some very attractive features. The process of using Invisalign is very much about the service. An intra oral 3D scan or impression of the teeth is sent to Invisalign along with a “treatment preferences” form. Invisalign uses the scan or impression to make a virtual model of the teeth, and then manipulates the model to accommodate the “treatment preferences” determined by the doctor. About 3 weeks after sending in the case, a file is sent to the doctor for approval to see if the doctor likes what is shown. By clicking okay the whole series of aligners from start to finish is made and shipped. They usually arrive after another 2 or 3 weeks. So it takes about 6 weeks to get the aligners to the patient, and that’s a bit longer to get started than most consumers would like.

However, there are a few drawbacks. Very little direct doctor involvement is required to achieve a set up using Invisalign. What if, out of a 20 aligner series, at aligner number 7 the computer model didn’t accurately simulate how the teeth would move? The answer…aligner number 7 doesn’t go in properly. So, what happens now? Aligners number 8 through number 20 will also not go in properly. The whole package of aligners from aligner number 7 forward is now a bag of trash...(At $160/pair, if you’re counting top and bottom together)...That's pretty expensive trash, $2240...Ouch!  As a practitioner, not only is the risk of wasted aligners a concern, but also what it adds to time in treatment.  Basically the “mid-course correction” process involves another scan and another 6 weeks waiting for new aligners to arrive.  Also, there is the “mid-course correction fee”...another ouch! I cannot speak for other professionals but I don’t charge my patients extra when appliances don’t fit. I eat the extra cost and lose money on those cases. So, if you’re wondering why Invisalign is so expensive everywhere…The risk of wasted aligners, and “mid-course correction” factors into case cost.

Dr. Aron Dellinger - Orthodontic Specialty Services | Clear Aligners

I actually stopped using Invisalign and started using another system called “Orchestrate” about four years ago. Orchestrate is a highly interactive clear aligner system. The system is similar to Invisalign regarding how the aligners are derived…except instead of having the company do the set up, I do the set up myself. Rather than treatment preferences that are generic to how I want to finish…I personally set up each specific case as I want the teeth to be moved at every stage of treatment. Also, instead of printing all of the aligners at once,  I print models of the teeth at the various stages and make the aligners in my own lab. I also only print three models in the series at any given time, so if there is an error in the predicted tooth movement very little waste of material, money and time has occurred.  Another advantage to Orchestrate is that I can see a patient for an exam, take a scan of the teeth, and give the first set of aligners to that patient in only three weeks, half the wait time of Invisalign!

What about DIY aligners?

I have a phrase for this one… “Don’t DIY healthcare!" There are so many things wrong with mail order aligners that it’s hard to find a starting point. First… no x-rays or CBCT imaging is used, meaning, you don’t know what is going on under the gums. Teeth can move where there is bone, and if you move them out of the bone they will be lost! Simply put you do not know if there is any bone around those teeth. Without x-rays there is no way to tell! Is there a disease process at work under the gum tissue that would compromise the health of the teeth if they are moved? Again, no way to tell without x-rays.

Moving your teeth, even a small amount, affects your bite, tooth wear, your facial muscles, and your jaw joint. Every day, I meet a new patient who has a very small concern, and we have a consult to discuss something like closing a small space between the upper front teeth. I take photographs, x-rays, look at the tooth charting and gum tissue probing depths sent from the dentists’ office, perform a range of motion analysis of the jaw joint, and then we discuss our findings. Interestingly, it almost never is as simple as just sliding the two front teeth together and done. The space got there somehow, and there is something making it stay. “Just a little cosmetic touch up” without big picture perspective almost always leads to excess tooth wear, damage to the enamel, sore muscles, and sore teeth.  Orthodontists have on average twelve years of college, and sometimes we get fooled by an easy looking case… DON’T TAKE CHANCES WITH YOUR HEALTHCARE!

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Patient Rewards

Patients will be rewarded points, redeemable for prizes! Successful orthodontics is a team effort and YOU are our key player! We have created the Smile Rewards card to recognize your accomplishments and congratulate your winning achievements. Our Smile Rewards card is an incentive program based on your compliance. You set the bar...every visit is an opportunity to earn points and cool prizes. Learn More

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