Bobbing for Apples in the Garden of Eden

For the last 104 years, orthodontics and orthodontists have enjoyed an idyllic existence within the profession of dentistry. Today we find ourselves in the platinum age of productivity, with income and job satisfaction at an all time high. Orthodontic treatment has become a right of passage for adolescents in America. Having achieved this level of success, we are eager to take the “next step.” But in what direction? Should we reach out or reach up? This article discusses several issues that impact the answer. The first concerns identifying the brightest and the best, the second, balancing supply and demand, and the third, weighing the cost and benefit of specialty training. Excellence in the 21st century will be linked to increasing the number of board certified practitioners, providing pro bono treatment for the underserved and shoring up the financial infrastructure of our specialty training programs. Or, in the words of Trevor McKinney, “pay it forward.”1