As I wrap up the final regular issue of 2009, I have two questions. First of all, how is it that no one has managed to come up with a catchy name for the decade we have just survived? "The Naughts" and "The Aughts" were flops. "The 2000s" is just confusing. I guess we'll have to wait for a future pundit to tell us what the past 10 years were really about.

Since the big picture is out of focus for now, my second question sets its sights on a smallish slice of the world. What I am wondering is this: What single development of this unnameable decade has had the biggest impact on how orthodontists practice? I asked my inner circle of orthos, and I got a wide range of answers.

Bad news first: "The single greatest (negative) change," went one response, "is direct-to-consumer marketing of orthodontics appliances and systems."

Another lament was that orthodontists are being taught "that we should aspire to be professional technicians instead of technical professionals."

Then there is the economy. In a time when unemployment is high and discretionary spending is low, one of my correspondents worried that "some orthodontists have no idea how to reduce costs or fees or even get closer to the patients and learn how to attract new ones."

On the positive side, many orthodontists touted the benefits of new technologies. One wrote, "The biggest change in ortho in the last decade has to be TADs. They have enabled us to produce movements that were previously difficult or impossible."

One respondent found it "tough to choose between the laser and SureSmile" as the biggest changes; another declared that "CBCT and 3D facial imaging have increased information exponentially."

Another answer called "unprecedented demand for orthodontic services that employ invisible or near-invisible orthodontic appliances" and "the routine incorporation of indirect bonding procedures" the most momentous change since 1999.

How has your practice changed for the better or worse since surviving the Y2K bug? I'd love to hear from you sometime in the next decade.

Christopher Piehler