In this short multi‑speaker dialogue, two dental practitioners (an orthodontist and a general dentist) share their frustrations with conventional extraction‑retraction orthodontic methods, which they feel can cause aesthetic, functional, and health problems such as collapsed occlusions, thin lips, TMJ disorders, sleep‑breathing issues, and chipped veneers. They recount discovering Bill Hang’s concept of Extraction Retraction Regret Syndrome (ERRS), which reframes these problems as a syndrome caused by space‑creating extractions and retractions. The speakers describe how ERRS‑focused protocols—re‑opening extraction spaces, creating tongue space, and addressing airway and jaw‑joint health—have transformed their clinical approach, leading to improved patient quality of life, new referrals, and a broader perception of themselves as healthcare providers rather than mere tooth‑straighteners. The discussion ends with a transition to a study club session.
Chapters
After 10 years in school becoming an orthodontist and taking on a mountain of debt, I started feeling like nothing more than a salesperson for the clear aligner companies.
As a general dentist, I was tired of patients with collapsed occlusions, thin lips, flat cheeks, and other aesthetic challenges. Many were complaining about pain patterns, sleep and breathing problems, and TMJ disorders.
Some of my referring dentists were criticizing my results too. Eventually, I had to admit that the retractive techniques we were taught in school probably carried inherent risks for some patients.
I couldn't find an orthodontist listen to my concerns. Out of frustration, I decided I had to learn how to do the ortho myself. All the dots connected when I heard Bill Hang talk about Extraction Retraction Regret Syndrome, or ERRS.
ERRS is a new way of thinking about orthodontics. Protocols for reopening extraction spaces and creating more space for the tongue are huge opportunities to help patients who want to avoid and reverse the effects of extraction and retraction.
ERRS explained why I was seeing so many chipped veneers, worn teeth, Scalloped tongues, and breathing issues. The sleep, TMD, ortho side of my practice is growing because of all the techniques I'm learning.
I feel like I've finally joined the healthcare profession. I'm doing a lot more than just straightening teeth.
This study club connected the dots between the symptoms I was seeing and the root causes of my patients' problems. It keeps giving me practical solutions I can use every day.
Airway and jaw joint health are part of every patient conversation. My practice is is very unique. I have more referring dentists than ever, and my new starts are up.
Now my patients see me not only as a dentist working on their teeth, but as a doctor who can help them improve their quality of life.
