If I had to suggest 2 factors that can influence growth of an orthodontic practice, improved access to care and active promotion of adult treatment are the first that come to mind. Surprisingly, these areas of focus have not been seriously explored as much as you might think in recent years. First, let me explain why I feel strongly about these issues and, second, how the actions of the American Association of Orthodontists (AAO) might lead to changes in your practice over the next year.

As a practitioner, I always tried to be the most accessible orthodontist in my community, stressing the value of inclusiveness by not charging a fee for initial examinations. Although many clinicians have strong reasons for providing free consultations, the owner of a radio station once told me, “If no one knows you provide free examinations, what good is it?” Ever since becoming a member of the Board of Trustees, I have suggested coordinating the promotion of free consultations for a short period of time, perhaps during National Orthodontic Health Month. Celebrating this event by all members who volunteer to participate would get more attention in the media than we could possibly measure in dollars. As evidence for this statement, I offer the recent experience of the American Optometric Association (AOA) with headquarters in St Louis, near the AAO building. About 3 years ago, that organization designed “InfantSEE” as a public health program managed by optometry’s charity, the AOA Foundation. Designed to ensure that eye and vision care become an integral part of infant wellness to improve a child’s quality of life, doctors of optometry provide an eye and vision assessment to infants free of charge regardless of socioeconomic status. It was promoted widely in the media and encouraged parents to bring their infants to see an optometrist earlier than normal when problems were suspected. National interviews and numerous articles provided positive support, and the examinations led to the diagnosis of serious problems that would have been overlooked. I remember having lunch with my optometrist at the time and talking with him on several occasions about the success of that program. He noted with pride, “Yes, the program has continued to be of value to the health of many children, and it was a winner for our association as well.”

In shifting attention to my second method of improving your practice, I looked no further than the recommendations derived from the most recent focus-group research survey commissioned by the AAO. Earlier this year, an AAO research team covered more than 8000 miles and hosted 12 focus groups in New York, Miami, Dallas, Atlanta, Denver, and San Francisco. All 120 participants had 4-year college degrees or more advanced degrees. As a part of their discovery, focus-group participants in all cities were actively engaged in discussions about orthodontic treatment and interested in overall health as well as dental health. Those involved asked several questions: among them, “Why do some adults with orthodontic issues seem to lack the motivation to address them?” Veteran orthodontists estimate that 40% to 65% of adults in the United States need some sort of orthodontic intervention. All but 4 of the 120 men and women who were participating acknowledged that they would benefit from orthodontic treatment. Many parents of children who received orthodontic treatment admitted that they were never asked by the orthodontist to consider treatment for themselves. There is a vast and growing market of college-educated, employed, upscale adults who exercise, watch what they eat, and listen to their doctors. The golden opportunity before the AAO is unlocking demand for orthodontists by adults determined to improve not only the appearance of their teeth but also form and function.

Among the many findings of this focus-group effort are the following.

• •

  The AAO should develop “guidelines for growing an adult practice,” a Web-based, step-by-step program that discusses how practices can be more welcoming to adults. Subjects include décor, noise level, privacy, dignity, magazine selections, and handouts to explain every step of the treatment process, including who does what and why.

• •

  The AAO, on behalf of its members, should undertake a sustained conversation with adults to ensure that this valuable market is aware of health issues and new treatment options.

• •

  Orthodontists, endodontists, and periodontists should form a coalition dedicated to shaping public policy to support free screenings for the 3 specialties and to provide greater insurance coverage for health-related dental and orthodontic procedures.

If sufficient numbers of members volunteer to support this effort, it will be recommended that free consultation strategies should be developed to promote the offer and be available for local customization through national print and online banner ads, local direct mail pieces, and regional press releases. Because some members continue to question the value of a national promotion, all communications and messaging will drive target audiences to www.braces.org to participate in the offer. The ability to track coupon downloads will provide the desired feedback from those actually seeking orthodontic care as a result of a free consultation. A motion is being considered by the AAO Board of Trustees to have the coupons run in national magazines and on national Web sites, and be referenced in radio ads. As it stands now, during February-May 2011 the AAO Consumer Awareness Program will promote the availability of free consultation coupons from participating members of the AAO.

Although the AAO has long championed access to care for everyone in need, there is no better way to express this policy than by jointly supporting a free consultation by a qualified orthodontic specialist at least 1 week a year. Follow this with a meaningful discussion of the benefits of adult treatment for the accompanying parents with children already in your office, and you’ve understood the heart of this editorial: the keys to a successful practice. Improved access to all in need supported by increased adult treatment will help every AAO member to be more productive.