Meeting Facility is Easily Accessible and Offers Many Amenities
Register now and join your AAO colleagues and members of the American Academy of Pediatric Dentistry in Scottsdale, Arizona, February 9-11 for "Early Orthodontic Treatment: Working Together for Excellent Results.” Twenty experts representing five countries will address topics of interest to orthodontists and pediatric dental specialists at the 2018 Winter Conference.

Save $100 by registering by the Early Registration deadline, January 12.
Learn More about the Winter Conference Program

The Winter Conference site, the Westin Kierland Resort & Spa in Scottsdale, Arizona, is unique in its celebration of the state’s cultural and historical heritage. The resort offers a wealth of family entertainment and outdoor recreation activities including three 18-hole golf courses.

Attractions in nearby Phoenix include the world-renowned Heard Museum of American Indian arts and cultures, the Desert Botanical Garden. The Talking Stick Resort Arena sports and entertainment complex is the home of the National Basketball Association Phoenix Suns, who have a game scheduled Saturday, February 10, 7 pm MST (vs. the Denver Nuggets).

Airport and Ground Transportation Information
Phoenix Sky Harbor International Airport (PHX) is located 20 miles from The Westin Kierland Resort & Spa. Amtrak, which frequently offers discounts on selected routes, has a stop at the airport.
Guest transportation to and from the resort is available via taxis at the terminals and  through Transtyle Transportation. Advance reservations for Transtyle are recommended. Enterprise Rent-A-Car is also available at the resort (480-624-1000).
Dec. 14, 2017

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Call Congress THIS WEEK to tell them not to use tax reform to make graduate medical education more expensive for the next generation of orthodontic students, or new doctors with outstanding student loans.

Congressional Action on Tax Reform

As Congress begins to work to resolve its differences between the House- and Senate-passed tax reform packages, the American Association of Orthodontists wants you to be aware of our ongoing advocacy efforts related to federal tax reform and encourage you to get involved. We are sending a letter to Senator Orrin Hatch (R-UT) and Representative Kevin Brady (R-TX), who will co-chair the conference committee working to resolve differences and agree on a final bill over the next week or so.

How it Impacts You

As you may know, the House Tax Cuts and Jobs Act (TCJA, H.R. 1) would eliminate several tax benefits which some of you may currently receive or have previously taken advantage of.  The Senate bill does NOT have these three provisions, which include:
  • Sec. 1201: Repeal of Lifetime Learning Credit (LLC), while not substantially increasing the American Opportunity Tax Credit (AOTC). The LLC provides a credit for 20 percent of up to $10,000 of qualified education expenses for postsecondary education. While there is no limit on the number of years the LLC may be claimed for each student, it does have an income phase out (between $56,000 and $66,000 and $112,000 and $132,000 for joint filers). The bill would eliminate the LLC while enhancing the AOTC slightly so that it would provide a 100 percent tax credit for the first $2,000 of certain higher education expenses and a 25 percent tax credit for the next $2,000 of such expenses. The AOTC would be available for a fifth year of post-secondary education at half the rate as the first four years.
  • Sec. 1204: Repeal of the Student Loan Interest Deduction (SLID). H.R. 1 would repeal the above-the-line deduction for interest payments on qualified education loans for qualified higher education expenses of the taxpayer, the taxpayer’s spouse, or dependents. The maximum amount of the deduction is $2,500, and only taxpayers with certain modified adjusted gross income qualify (phases out between $65,000 and $80,000 for individual filers, and between $135,000 and $165,000 for joint filers for 2017).
  • Sec. 1204: Repeal of Qualified Tuition Reductions. Under current law, qualified tuition reductions provided by educational institutions to their employees, spouses, or dependents are excluded from income. The exclusion may be provided in the form of either reduced tuition or cash. These may not apply to graduate programs, except for a graduate student who is teaching or a research assistant.
If your current tax status would be affected by these items, we understand your concern and are working to try to prevent the foregoing from becoming law.
While the House TCJA would double the standard deduction to $12,000 for individual filers (and $24,000 for joint filers), we understand that those of you who are affected are concerned about losing the benefits noted above. The Senate TCJA (S. 1) keeps intact each of the education benefits above while also doubling the standard deduction. In other words, the Senate bill is likely more favorable for orthodontic residents, students and young doctors with significant student loan debt.

What You Can Do

If you are impacted or concerned by any of the above provisions that would be eliminated in the House bill, we urge you to contact your Representative and Senators to ask that the final conferenced tax reform package retain the Senate language, which preserves important benefits for graduate students and recent graduates. Include how this impacts you and your family directly. Congress is in the final stretch to agree on a final bill, and your voice matters!
You can find your Senator, by clicking here:
You can find your Representative, by clicking here:
Do not hesitate to reach out to the AAO with any questions or if we can be of assistance - we are happy to help you get the word out. Below is a sample email/call template you can use for your outreach.   Action should be taken before Friday December 8, if possible, as we expect the conferencing process to move quickly. We encourage a phone call as the best method of communication or you can send the sample email below. 
SAMPLE TEXT FOR CONGRESSIONAL OUTREACH (if calling the Congressional office to relay this information, be sure to ask to speak to the staff member who handles tax issues, though you may have to leave a detailed message with the person at the front desk instead)
**Please personalize to tell your story.**
Good morning/afternoon/evening,
My name is ______, and I live in [city, state]. As the House and Senate work to resolve differences between their respective tax reform packages (H.R. 1 and S. 1), I urge you to retain the Senate language that protects graduate student and borrower benefits. These benefits currently make an enormous impact on my financial stability and ability to repay my loans. For example, I am an orthodontist/orthodontic resident and currently have $[enter student loan amount] in student loan debt. If I were no longer able to [deduct the interest paid on that amount/deduct a minimal amount of my graduate school costs/exclude from income my tuition waiver], it would compound the burden I already face with my current debt load. These benefits provide extra incentive to help me repay my loans sooner. Future borrowers may be dissuaded from entering the field altogether.
Thank you for your attention and I hope you will work to preserve these important student borrower benefits.  If I can be of further assistance to you on these issues, please contact me at [phone number/email].
[your name]
Dec. 6, 2017

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Serving on the front lines in helping students remain healthy on a day-to-day basis, school nurses have opportunities to intervene in situations related to students’ oral health, and to educate students and parents. To help inform these busy professionals, the AAO recently sent a mailing to school nurses who are members of the National Association of School Nurses, and to nurses at schools that are members of the National Catholic Educational Association and the National Association of Independent Schools.

Topics addressed in the school nurse mailing include:

♦ Signs that a student may be attempting to perform do-it-yourself orthodontics (Beware of Do-It-Yourself Orthodontics (for school nurses);
♦ How to handle orthodontic emergencies, especially appliance-related problems for which students may come to the school clinic (Handling Orthodontic Emergencies);
♦ The importance of mouth guard use to prevent or minimize oral injuries, and what to do if teeth are loosened or knocked out.(Dental Trauma - Prevent Accidents But Know What to do if One Occurs).

AAO members are also welcome to download the materials listed above for local outreach to school nurses. Each one is designed to serve as a leave-behind with the “Handling Orthodontic Emergencies in the School Clinic” PowerPoint Presentation for school nurses. To download the presentation and prepared script, click here; then scroll down the page to view the presentation links.

Members may also wish to consider providing local school nurses with the tools and supplies mentioned in the “Handling Orthodontic Emergencies” flier. Building good relationships with school nurses may lead to opportunities to give presentations to classrooms or parent/teacher organizations. 
* Members who download AAO materials are welcome to customize them, per the rules in the AAO Logo Standards Manual and Guidelines for AAO members’ Use of Marketing and Communications Materials. Software like Adobe Acrobat Professional or graphic design software will be needed to add text and graphics such as a practice logo to a PDF.  If you do not have the necessary software, a local graphic designer would likely be able to do the work. Stores like Staples, FedEx, UPS Store, or other quick-print shops may also be able to make revisions.
Dec. 5, 2017

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Participants in a recent meeting in St. Louis began the process of updating the AAO Strategic Plan. Those in attendance included representatives from the AAO Board of Trustees and councils, House delegation chairs, an orthodontic resident, a consultant, a manufacturer, a dental service organization representative and 10 at-large members (whose selection was based partly on diversity considerations), as directed by the House of Delegates. The Strategic Plan addresses critical issues facing AAO members and the association, and includes goals and actions to address the issues.

The 2017 AAO House of Delegates approved a new strategic planning process for the association, designed to broaden participation. The House called for a larger group of stakeholders to meet in person to ensure that the plan captures the diverse perspectives of members and others who influence orthodontics. In accordance with the House directive, the Global Strategic Planning Committee was formed.
The committee’s first planning meeting was facilitated by consultants from McKinley Advisors and included presentations of market research and data from AAO member surveys. Small-group discussions focused on examination of the AAO’s current mission, desirable strategic priorities for the AAO to pursue during the next few years, areas of opportunity, and goals and objectives necessary for future AAO success.

A short video filmed during the meeting includes comments from Global Strategic Planning Committee members including Dr. Brent Larson of Minneapolis, president-elect; Dr. Blair Struble of Bend, Oregon; Dr. Greg Jorgensen of Rancho Rio, New Mexico; and Dr. Sylvia Frazier-Bowers of Chapel Hill, North Carolina. The committee members reflect on how the strategic planning process can serve orthodontic patients and the specialty effectively and ensure that the AAO’s future direction reflects the needs and priorities of members.

View the Strategic Planning Video
Dec. 5, 2017

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Each year, several hundred AAO members take on leadership and other volunteer responsibilities within constituent and component organizations; on AAO councils, committees and task forces; and in the House of Delegates. A new online resource, the Leadership Network, provides volunteers at all levels with information and tools designed to help them understand the workings of our complex organization and perform their duties more easily, efficiently and effectively.

“In 2016, the House of Delegates called for a task force to explore how the AAO could support constituent and component leaders,” said Dr. Ken Dillehay, AAO trustee and chair of the Component Support and Leadership Development Committee. “Our committee was formed to address this directive. We were also asked to re-develop the former President-Elects Conference (now the Leadership Development Conference.)”

“We knew that we had many resources that would be helpful to constituent and component leaders, but there was no centralized repository that leaders could simply visit when they were unsure what to do,” said Dr. Gary Inman, AAO trustee from the Southern Association of Orthodontists and a member of the Component Support and Leadership Development Committee. “The committee worked tirelessly for two years to develop our resource repository, the online Leadership Network,”
“In addition to functional leadership questions, when leaders are newly elected, it is also important that they begin quickly to learn about the overall structure of the AAO,” said Dr. Dillehay. “Being knowledgeable of the overall organization enables a new leader to identify resources easily and work more productively and effectively. The Leadership Network is a user-friendly resource for members to use in this way.”

Leadership Network is Available to all AAO Members
“We believe the network provides a valuable service to our leaders, but also may be helpful to many who are not in AAO-related leadership roles,” said Dr. Inman. “Any AAO member may be interested in learning about leadership opportunities and how their talents and expertise may be of use. Or, they have questions about an issue of concern and need to know which group within the organization handles that issue. In addition, the network may also be helpful to AAO members who are engaged in other types of organizational leadership roles, whether a dental organization, a local civic, school or church group, or a charity.”

Visit the Leadership Network at to access the resources outlined below.

Orientation for New Leaders
The Leadership Network home page provides access to the concise guide, Orientation Part 1: An Overview, which covers:
AAO Leadership (decision-making and who does what). A concise but thorough overview of how decisions are made within the AAO, and how recommendations are considered by the Board of Trustees and/or House of Delegates, and then acted upon. Includes quick reference information regarding the roles and functions of AAO leadership entities, the work of councils and committees, and the advisory and implementation roles of AAO staff;
Governance (incorporation of member perspectives). An explanation of the governance function, including how member feedback is gathered and incorporated into decision-making by the Board of Trustees and the House of Delegates;
Structure (operations and financial status). An overview of how and why the AAO operates as it does due to its not-for-profit status, and the operations of constituents, components, councils and committees;
Constituents and Components. A guide to the constituent regional breakdown and governance overview of these organizations.
Councils and Committees. A summary of the functions of councils and committees, with a link to a PowerPoint presentation that provides in-depth information about their work.
Strategic Planning. A guide to how the AAO Strategic Plan is updated and presented for consideration by the House of Delegates.

In addition to the Councils and Committees PowerPoint, multi-media features of the orientation include:
♦ A video featuring Dr. Gary Baughman, past speaker of the House of Delegates, and James Lochrie, former parliamentarian (in the Governance section). They provide a simple overview of how the House of Delegates works;
♦ Organizational and decision-making charts in the AAO Leadership and Structure sections that provide visual support to clarify the organization-wide input and decision-making processes.

After review of Orientation Part 1: An Overview, leaders are encouraged to take the virtual course, Orientation Part 2:  A Deeper Dive. This program more closely examines the AAO's governance structure and how each entity plays a role in guiding the direction of the association. Viewers also learn how leaders establish the direction of the AAO and the legal obligations of leaders. The program includes PowerPoint presentations and videos.

Services, Tools and Contacts for Leaders
The following sections of the Leadership Network are also helpful with many questions and dilemmas faced by leaders:

AAO Services to Constituents and Components. The Leadership Network also provides a guide and contact information for all AAO personnel who routinely provide guidance and consultation to constituent and component leaders. Contacts come from the areas of accounting and finance, administrative and member support, legal and advocacy, marketing and communications, meeting and event planning, and volunteer management.

Officer List and Information. This section offers each organization access to leadership contacts from other constituents and components, as well as a form for uploading contact information for newly elected leaders.

“We wanted to develop an easy way for leaders to identify contacts from other groups with whom they could network, exchange ideas, get recommendations for conference speakers, or whatever they might need,” said Dr. Dillehay.

Meetings and Events. This page offers each group the opportunity to list its upcoming meetings, see when neighboring components’ meetings are scheduled, etc.
Tools and Resources. This section offers many types of information designed to meet the needs of leaders as they carry out their functional roles. Whether you need an event planning checklist, the application for AAO Component Legal Support funding, suggested volunteer interview questions, or a guide to running an RFP process, the Tools and Resources section will help address many questions.

Leadership Development Conference Training Augments the Online Network
The 2018 Leadership Development Conference will offer constituent and component presidents-elect or their designates the opportunity to receive high-level leadership training from experienced AAO leaders and other experts on leadership. The conference will be February 8, 2018.
Learn More about the Leadership Development Conference

Nov. 22, 2017

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The AAO Component Support and Leadership Development Committee has announced that registration is open for the 2018 Leadership Development Conference. The conference will be Thursday, February 8 at the Westin Kierland Resort in Scottsdale, Arizona.

The conference is open to constituent and component presidents-elect, or fellow officers whom they have designated to attend.

“This meeting is an updated version of the former President-Elects Conference,” said Dr. Ken Dillehay, the AAO trustee representing the Southwestern Society of Orthodontists and chair of the Component Support and Leadership Development Committee. “We will cover many topics helpful to newly elected leaders, such as how to run a meeting, recruitment of volunteers, legal responsibilities, advocacy, marketing and AAO resources. In addition, we will have in-depth discussion of effective leadership.”

Leaders who participate in the conference may elect to stay in Scottsdale for the 2018 Winter Conference with the American Association of Pediatric Dentistry, “Early Orthodontic Treatment:  Working Together for Excellent Results (February 9-11). In appreciation of their service, each Leadership Conference participant will receive a $100 discount off the Winter Conference registration fee.
Click Here to Register for the Leadership Development Conference
(Please confirm your eligibility to attend by checking the criteria listed in the second paragraph of this article.)

The Leadership Development Conference will take place every year. Between conferences, constituent and component leaders and other AAO volunteers are encouraged to use the new online Leadership Network. The network, which is available to all AAO members, is a centralized repository of many types of information and resources that the Component Support and Leadership Development Committee identified as being helpful to leaders and volunteers at all levels.
Learn about the Leadership Network
Members of the Component Support and Leadership Development Committee who worked with Dr. Dillehay and AAO staff on the planning of the Leadership Development Conference include Dr. Frank Beglin of Carson City, Nevada; Dr. Charles Chance of Sweetwater, Tennessee; Dr. Gary Inman, trustee representing the Southern Association of Orthodontists; Dr. Valerie Martone of Beaver, Pennsylvania; Dr. Carolyn Melita of Belmont, Massachusetts; and Dr. Steven Siegel, the trustee representing the Middle Atlantic Society of Orthodontists. The committee also includes two members with extensive experience in constituent organization management: Sharon Hunt, who retired as executive director of the Southern Association of Orthodontists, and Debbie Nunner, director of the Great Lakes Association of Orthodontists.

Nov. 22, 2017

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by Paul Zuelke
In 1980, I started my career as an orthodontic consultant focusing exclusively on teaching our clients how to grant credit (payment plans) to their patients in a manner more appropriate than what was currently being done by the profession. I had spent 10 years in the banking/lending industry and had learned that orthodontists were routinely suffering from poor case acceptance and high delinquency because they were, essentially, required to grant credit to their patients, but they had no proper training regarding how the credit granting process should be implemented.
Back then, most orthodontists had a, more or less, fixed financial policy that put virtually all new patients into the same “bucket” and allowed them a payment plan with a required $X down payment and a required X number of months to pay. Some practices had very strict policies requiring large (20 percent-plus) down payments and limiting financial arrangement length to 80 percent of treatment time, and other practices allowed 5 percent down and payment plans at 100 percent of treatment time.
No matter the financial policy, the result was poor case acceptance on some of the highest quality patients because the required down payment and/or monthly payment was more than the patient/parent was comfortable with.

All practices had high patient delinquency along with the resulting problems including failed/cancelled appointments, poor clinical cooperation, patients in treatment longer than diagnosed treatment time and all of the other problems associated with patients/parents being in a negative relationship with the practice on the subject of money! The greatest problem of all, though, was something that almost no orthodontists recognized:  The poor rates of case acceptance caused by a very low percentage of new patients being referred by existing patients.
It is a fact that patients out-of-relationship with a practice because of delinquency will not refer friends, relatives, or co-workers to the practice. It is also a fact that of all sources of patients (community marketing, doctor referrals, etc.) coming to your practice, those who are direct referrals from your existing patients have a case acceptance rate that in most offices is 80 percent-85 percent.
Compare that to the 60 percent case acceptance that is typical of patients coming as a result of dental referrals. 
Still today, 37 years later, most orthodontists are putting all of their patients into the same financial “bucket” with a more or less fixed financial policy that is applied equally to all patients and without any consideration at all to the level of maturity, stability, and credit worthiness of the responsible party.
A few orthodontic consultants and a few more “guru” orthodontists are against the concept of obtaining a credit report and/or making a credit evaluation of patients in order to make financial arrangements proportional to risk. They believe, incorrectly, that having strict financial arrangements on the small percentage of patients with horrible credit damages the ability of a practice to grow. Those who are opposed to the idea of obtaining a credit report and using risk information have a goal limited to having a great big practice. They seem to believe that having a large practice is the be all and end all of practice “success.”
Zuelke & Associates’ purpose for recommending credit evaluations is also to grow the practice. Since our history has proven that our clients’ new patient flow, case acceptance rates, and annual production and income are substantially greater than that of the national average, we know that our purpose is being accomplished. (As of March 2017 our average single doctor practice is producing $179,000 per month.)
“A” category patients make up 65 percent to 75 percent (80 percent to 85 percent is some practices) of all new patient exams. Since such patients are allowed $0 down payment when necessary and are allowed long term - even longer than treatment time - payment terms when necessary, case acceptance on those “A” category patients goes up far more than the case acceptance that is lost by the financial restrictions on the 25 percent to 35 percent of patients in the “B” and “C” risk categories.
However, the goal behind our credit evaluation recommendations is also to create quality of life within the practice by avoiding the serious problems associated by bringing high risk patients into the practice in a financially out-of-control situation. 
Those consultants, dentists, and orthodontists who say that you can bring a high risk person into the practice by offering a $500 or lower down payment and long term (even longer than treatment time) financing, and do that without terrible patient related problems as a result, are simply not telling the truth. I have aggressively studied this issue for 45 years since I entered the financial world and I have learned a few things. The 37 years that I have focused on orthodontic patient financing have taught me a few more things. For instance, 90-plus percent of high risk patients who are financed in the practice will become 30-plus days (two payments) or more delinquent. Fifty percent of those will become delinquent before their new account has been on the books 90 days. That is true whether the practice gets a $500 down payment or a $2,000 down payment.   
The very small percentage of new patients in the high risk categories, defined as the “B-” and “C” patients, live a lifestyle and/or have a level of integrity that makes the odds of such a patient paying properly on a payment plan almost zero.

Note that poor people do not necessarily have worse credit reports than do people who are better off socioeconomically.  In fact, there’s a pretty good argument that those at the lower income levels may well have generally better credit reports (lower credit scores probably, but better credit reports). 
About 80 percent of all patient delinquency experienced by orthodontists is due to what I call “integrity” issues.  Very little delinquency is due to the inability of a responsible party to actually pay the bill.  In the simplest terms, people with a high degree of integrity will compromise their lifestyle (go to the movies less often, purchase a less expensive car, etc.) in order to be able to maintain their integrity (such as to keep their financial agreements).  People with a lower level of integrity will tend to maintain their lifestyle, even when money is tight, and simply choose not to pay certain bills, such as the orthodontist.  That’s why we recommend that orthodontists obtain credit reports (not credit scores!). You cannot ascertain integrity from a Patient History form or from an interview with a patient/parent.  You can identify integrity from a thorough review of that person’s credit report.
The good news is that the level of integrity that causes a responsible party to pay their bills on or before their due date is the same level of integrity that causes them to show up on time for appointments, follow doctor’s clinical instructions, teach their kids to brush properly, etc.
So, you may ask, if our high down payment requirement does not stop high risk patients from becoming delinquent, what’s the point?  The point is that high risk patients put into treatment without appropriate financial arrangements cannot be controlled once they inevitably become delinquent. They have no “equity” in their treatment. Just as 95-plus percent of all foreclosures/repossessions of automobiles, homes, RV’s, furniture, etc., have loan balances greater than the value of the product being purchased (hence, the debtor allows the repossession), so also do practices have tremendous financial loss when they allow high risk patients into the practice with low down payments and long term financing.
Again though, the financial loss these practices suffer, while significant, is nothing compared to the clinical, administrative, and social problems that these practices have with these financially out-of-control patients
These same high risk patients, when started with appropriate down payments and payment plans, have substantial equity in their case and when they inevitably become delinquent, a practice with even a reasonably good delinquency control program will be successful, well over 80 percent of the time, in keeping the account under control and being appropriately and fully paid while the patient remains clinically cooperative.
So, is getting credit evaluations and structuring financial arrangements according to risk for everyone?  Nope! It’s not. If negative relationships with a lot of your patients, too frequent instances of poor clinical cooperation, missed appointments and a lousy rate of patient referrals are things you choose to live with - as long as the result is a “big” practice - then credit evaluations are not for you.
On the other hand, you can go onto the web and in 45 seconds, and for $6, obtain a 100 percent accurate credit grade along with a specific recommendation for a down payment and contract length appropriate for the risk ( By doing so (and assuming you pay attention to the recommendation) you will enjoy much improved case acceptance among the vast majority of your new patients who are low risk.

You will, of course, lose a few points of case acceptance with the much lower number of high risk patients who are unable or unwilling to pay you appropriately. Again, though, the case acceptance gain among the “A” patients significantly exceeds the loss of starts from the “B” and “C” categories of patients. As a result, you will enjoy a practice filled with high quality patients who are paying you perfectly, along with 20 percent-25 percent of your patients of higher risk but under perfect control. The result, 100 percent of the time, is a highly profitable practice and a doctor and team enjoying strong relationships with all of their patients and a great quality of life within the practice.
Paul Zuelke is president and founder of Zuelke & Associates, Inc., provider of superior management strategies which build productive and highly profitable orthodontic and dental practices. Mr. Zuelke may be contacted at or
Nov. 22, 2017

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