Hello welcome to dentistry 101. Today I'm here with Dr. Nan Hatch who is from the University of Michigan School of Dentistry. She is the chair of orthodontics and periodontic dentistry. And she has completed her training at the Harvard School of Dental Medicine and the University of Washington where she did her orthodontics degree and a PhD, and then she came to Michigan. We were lucky to get her here to do a fellowship and regenerate medicine and now she is our full faculty member that we're delighted to have you here today. So, Dr. Hatch, I want to ask first off, what does an orthodontist do? What does an orthodontists do? Well, orthodontists work on the oral cavity, we straighten teeth. One component of that is the teeth and another component of that is the facial skeleton. So, we look at people's faces and we look at their teeth and we decide if things aren't fitting together. Well, is it because the teeth are out of place, is it because parts of the face or not in the right place or a combination of both? Then most commonly, we use braces, brackets and wires for six months up to two years of treatment to get everything nice and straight, functional in the back, beautiful smile and on more complex cases, we work with other dental specialists such as yourself a periodontist, and we also in some more extreme cases, work with oral surgeons and ortho-maxillary facial surgeons who may re-position one or more part of the face. So, tell me a little bit about what the general orthodontist would do and where's the common treatments they would be doing on a day to day basis? On a day to day basis, the vast majority of patients we see are kids usually ranging from six to say ten would get interventive treatments, ahead gear and expand limited appliances that will make things easier later and then the rest of our patients were doing what's known as comprehensive orthodontics. Its full braces, upper and lower. We treat both children and adults. That's what we do. So, the best part is when people come in and they won't smile and show their teeth and by the end of the treatment, they will give you a nice big confidence smile. That sounds like an incredibly rewarding aspect of dentistry. I'm curious when you- what got you interested in orthodontics, to begin with? How did you get there? So that is interesting and perhaps a little bit different than many other orthodontists. I have no orthodontists in my family, I actually did not have orthodontic treatment as a child. So, I was not aware of it as a dental specialty until dental school, and when I was introduced to it, I was just drawn to it because of the combination of as- much of dentistry is of mind and handwork, every patient is a puzzle, the pieces aren't fitting together well and you have to figure out the best way to get the pieces to fit together well to make them functional as well as as the most attractive version of themselves that they can be. So, how do you become an orthodontist? So, like the rest of dentistry, four years of college, then four years of dental school and then you do an orthodontic residency training program in this country. It'll be a two to three year program. What sort of additional classes do they take when they're being trained as an orthodontist? There's multiple sides to this, right. So, there's the treatment mechanics part. Like how do I use the braces? How do I move the teeth? The basic physics that go along with that. Then there's growth and development. So, if I see a child, are they growing normally, is their face or their jaws growing normally and can I predict future growth and can I manipulate future growth with use of different appliances that we use? Then there's the biology behind all of it. How do teeth moved through the bone? How does this all happen? When you go to an orthodontist, they're often very innovative in their thinking and training. What's coming down the pike for orthodontics? What's new on the horizon that our listeners might see you in the future? I would say the number one thing and I think this shift is consistent. What is happening with dentistry in general is the incorporation of naval more modern technologies that are relevant to the fact that we are more computer and digital based these days. For example, the old, I put a bunch of goo and a tray and put it in your mouth so that I can have a record of your teeth to diagnose you when you're not in the chair, we're pushing that to the wayside and now we're using an intraoral scanner which is a wand that you stick in the mouth and it just takes a whole bunch of pictures and then you're able to generate a three-dimensional image of the mouth that way. Also, we're moving into 3D printing so that you can print somebody's skulls, you can print somebody's teeth, you can potentially, likely in the next several years, is going to be able to print some of our appliances. There is a lot of computer work now that's being incorporated into the world of orthodontics. So, you're also a researcher. Tells us about how your research informs your practice and what's something that's cool that you can tell our audience about your own work?. Let's say, I have a passion for orthodontics. I love orthodontics. It's a great field. I also have a passion for research. The primary bulk of my research time is trying to understand processes that control development of the facial skeleton and the skull bones. So, there's a subset of orthodontic patients that are born with cranial-facial anomalies. So, they are born with abnormal facial shapes, abnormal skull shapes and there are medical issues that go along with this as well as social issues, because the face is extremely important for social interactions. So, I study that at a fundamental level and also work on a translational level to test new drug therapies to try and intervene in some of these situations where right now all they have is a surgical approach. Are their specialties within orthodontics that focus on that?. They absolutely are and we have what's called a cranial-facial orthodontics. So, at our school and there's about, I think there's about seven of them now. They're called cranial-facial fellowships. So after you've done your two to three year orthodontic training, you can opt to do another year that sub-specializes is in treatment of these cranial-facial patients, and then typically, you would go on to be on a cranial-facial team where you work with all of the other providers for these care, these children in concert throughout their childhood. Well, it sounds like that would be an incredibly important aspect of dentistry and very rewarding for many patients especially if you can change somebody's outlook and their projection into the future as to what their lives might be. The last question I wanted to ask you is, what gets you excited about dentistry? I am excited about dentistry because of the combination of my handwork. I've always enjoyed working with my hands but I also enjoy puzzles, and thinking, and ideas, and asking myself questions, and seeing if I can answer them myself or ask somebody else or look in the literature and dentistry is absolutely that combination, right. So, the vast majority of patients once you're a well trained orthodontist, you know how to treat them. But there's always that patient that walks in whether, it's a cranial facial anomaly or some other issue going on, where you really have to be ready to jump back into that educational continually learning process to address a patient's needs. Well, tell us a little bit about some of the most rewarding parts of orthodontics. Well, there's one aspect of orthodontics that I think some people don't get until they're actually in the field or know somebody who is in the field. In that state, you really have a place to be a role model for your patients, for the children, for the teenagers. You develop real relationships with these patients because you see them on a monthly basis for up to two years and maybe even longer during [inaudible]. You develop relationships with their families as you treat multiple siblings within a family. And so there's really a personal connection that develops. That's very rewarding when you watch these children bloom into young adults. It's a great place to be. Thank you Dr. Hatch. That was very informative. It was very inspirational to hear about all the aspects of orthodontics and all their treatments and leadership that the profession provides for our patients. Want to thank you and I'm sure our listeners will be very inspired. So, thank you again.