Dr. Ryan Swain is the CEO and founder of Six Month Smiles, Inc. He practices in Scottsville, N.Y., and focuses exclusively on short-term orthodontics and other forms of minimally invasive cosmetic dentistry. He is an international lecturer and author on topics including short-term orthodontics, occlusion, leadership, cosmetics, and business. One of his primary missions is to help make orthodontics accessible for general dentists and adult patients. Dr. Swain can be reached at [email protected], or for more information call (585) 571-4732.
Dental Economics: Thank you Dr. Swain for taking the time to answer some questions about the Six Month Smiles Short-Term Orthodontic System. There is a tremendous amount of buzz around Six Month Smiles and general dentists doing cosmetic orthodontics. Since most GPs typically don’t do fixed orthodontics and the idea of “straight teeth in six months” seems counterintuitive, I’m excited to give you an opportunity to answer some questions. I believe that adult orthodontics is an important topic that has not been sufficiently focused on by our profession. I’d like to learn more about the Six Month Smiles and ask some questions that I’m sure many of our colleagues have about the system.
Dr. Swain: I agree with you that the area of adult orthodontics has been one that our profession has not adequately focused on. Back in 2003, I was working as an associate dentist and was amazed by how many adult patients with crooked teeth were asking me if there had been recent advancements in orthodontics. These patients were very unhappy with the appearance of their teeth and were stuck with no options that were acceptable to them. Hardly any of these patients would accept a referral for conventional orthodontic treatment because of the years involved and the appearance of metal braces. I took proven orthodontic methods, tweaked them slightly, and started developing a more time- and lifestyle-sensitive approach to providing a solution for these adult patients and to grow our practice at the same time. This became the Six Month Smiles Short-Term Orthodontic System. I wasn’t the first dentist to offer a more rapid orthodontic option to patients. What I did was to develop a training protocol and unique materials that made the process easy and accessible for GPs.
DE: Can you describe the system and how it is possible to accomplish orthodontic treatment in six months?
Dr. Ryan Swain: The best way for me to explain the system and how it works is to say that it is like clear aligner systems, but with some significant benefits. The system involves the use of specific clear braces and tooth-colored wires to provide adults with straight teeth in an average of just six months. The scope of treatment and the patient population is very similar to that associated with aligner systems like Invisalign®. And like aligners, Six Month Smiles is not an exact replacement for comprehensive orthodontics. The treatment goals are more cosmetically focused. For most cases, we’re not changing angle class or moving the roots of the teeth substantially. This shift in treatment goals, along with the unique brackets and wires, are what make the short treatment times possible. The prescription built into the Six Month Smiles brackets is specific for achieving short-term orthodontic treatment goals.
DE: When I first heard about Six Month Smiles, the first question that came to mind was “What about root resorption?” I’m sure you’ve heard this question before from other dentists.
Dr. Swain: Yes. Most of us learn very little practical orthodontic information in dental school. We are essentially taught how to diagnose a malocclusion and then refer the patient to a specialist for comprehensive treatment. One other thing that we are told is that if teeth are moved too fast, the roots of the teeth can shrink. Root resorption is a real phenomenon that we have all seen on X-rays. However, there is no increased risk of root resorption with Six Month Smiles. In fact, there is less opportunity for root resorption because the forces placed on the teeth are extremely light and there is simply less treatment time for resorption to occur. The short treatment times are possible because of the cosmetically focused treatment goals and the unique brackets and wires.
DE: You mentioned that Six Month Smiles is similar to aligners in some ways. Can you compare and contrast them?
Dr. Swain: Aligners have provided an easy way for general dentists to start offering orthodontics in their practices and the idea of achieving straight teeth without metal braces is an attractive proposition for patients. Unfortunately, aligners are not the panacea that we all hoped they would be. It is incredibly hard to control tooth movement with aligners. Certain movements like rotations and extrusions can be very unpredictable, if not impossible. This is frustrating for dentists and patients because cases tend to drag on and it is very difficult to predict treatment times. Aligner costs are high too. Rather than aligners, the Six Month Smiles System involves clear brackets and wires that allow for reliable and efficient tooth movement. The cases are set up in the Six Month Smiles case processing facility by highly experienced bracket specialists. Based on the desired outcome, the brackets are pre-positioned in custom bonding trays. A general dentist with no ortho experience can learn how to use the system and easily bond brackets. The wires have shape memory and work in conjunction with the brackets to gently move the teeth into their final position. The clinician sees the patient every four weeks and guides the process along, working through a three-wire sequence and making any adjustments as needed. Additionally, the costs associated with Six Month Smiles is about one third that of aligners.
