In this presentation, the speaker warns orthodontists that direct-to-consumer aligner companies like SmileDirectClub could soon treat more patients than traditional orthodontists, threatening the profession’s viability. He introduces the concept of Extraction Retraction Regret Syndrome (ERRS), describing a 1989 case where aggressive forward movement of teeth dramatically improved a patient’s facial structure and eliminated chronic headaches, despite initial warnings about potential gum recession and other complications. Citing at least eight peer‑reviewed articles, he argues that substantial tooth protraction can be performed safely without causing gum recession. The speaker advocates a paradigm shift from reactive retraction to proactive, preventive orthodontics, urging practitioners to view teeth as integral to overall health, adopt innovative techniques, seek mentorship, and collaborate to prevent ERRS rather than merely treating its consequences. He calls for open‑minded innovators to join a community focused on education, mentorship, and practice transformation.
Chapters
I think you're going to see many orthodontists who will be in the same boat that the New York cab drivers are in because of Uber and Lyft. A year and a half ago, a former orthodontic department head predicted that within 5 years, SmileDirectClub would treat more patients than all of the orthodontists in the United States combined. How are they going to survive? They're going to have to get out of the profession entirely, or they're going to have to come in and understand that those teeth are actually part of the body. 30 years ago in 1989, I had a woman who came to me. She'd had 2 lateral incisors taken out of all things. Her face was completely caved in, and she had, she had a headache pattern going on all the time. I thought of everything negative that might happen. I told her, if I push these teeth I might cause your gums to recede. I might push your teeth— you might need to see a periodontist. I might push your teeth so far forward they'll fall out. You might lose teeth. I might put them into a big open bite, and the only way to correct that would be jaw surgery. To every one of my warnings to her, she said, I don't care. So I tried. It literally changed her face like crazy. I was terrified. Her pain pattern went away, and 30 years later, her pain pattern is still gone. We're in orthodontics, we're bright people, or we wouldn't have been accepted into the program. We can think on our own. There are at least 8 articles in the refereed literature stating that you can push the teeth forward like crazy and not cause gum recession. I came up with the term ERRS, which was extraction, retraction, regret syndrome. It's about life. It's about breathing. We're dealing with an epidemic, and if you don't believe me on this, you haven't asked the right questions, and you're part of the problem. We're here to change the orthodontic profession. We need to have innovators come into this and realize that orthodontics and dentistry is really part of healthcare. It's the critical part of healthcare. What I'm looking for is people who are open-minded, who realize that there has to be a better way and who want to, want to learn a better way. We want to prevent the problem. We want you to have confidence in your ability to treat cases without retracting. As Omar Reed said, if it's been done, it's probably possible. I've been not retracting for decades now. It works for me. I haven't pushed all the teeth off the bone support. I haven't produced faces that look ridiculously full. As a matter of fact, people come to me because they want what I produce. We want to, A, be able to treat the people who suffer from ERRS, but more than that, in our, in our group here with ERRS, we're bringing forward ways to hopefully prevent it. We don't want to be treating it. Why do you want to be fighting fires when you can be preventing fires? It takes a long time. And much repetition, and they need some mentorship and some hand-holding to really help people understand exactly how to do this stuff. There's a zillion mistakes to make along the way. Trust me, I've made them. I want to share that expertise with other people. I want to help other people, help professionals, help dentists who do orthotics, help orthodontists change their practices and prosper and, and have people who are willing to try travel from all over the world to see them like they do to see me.
