Pacific Coast Society of Orthodontists Bulletin Winter 2022 - 38

Clinical Practice
Let's Talk About That
Dr. Patrick Turley Interviews Dr. Vince
Kokich Jr.
In this issue's Let's Talk About That, I have the
pleasure of interviewing Dr. Vince Kokich Jr. Dr.
Kokich Jr. lectures worldwide on the topic of
interdisciplinary treatment, and in this interview,
he will focus on ways to better help our patients
understand and visualize the treatment that is
being proposed for them.
Dr. Patrick Turley
PCSO Bulletin Editor-in-Chief
Dr. Vince Kokich Jr.
Tacoma, WA
Dr. Kokich Jr. received his dental degree from Tufts
University and his master's degree in orthodontics
from the University of Washington, where he
teaches part time as an affiliate assistant professor
in the Department of Orthodontics. He is a
diplomate of the American Board of Orthodontics
and a member of both the Angle Society and
the American Academy of Esthetic Dentistry. Dr.
Kokich Jr. lectures nationally and internationally
on interdisciplinary dentistry and dental esthetics,
emphasizing comprehensive treatment planning
and the importance of properly sequencing orthodontic,
periodontal, and restorative treatment.
Dr. Vince Kokich Jr. (VK): " When establishing
value in the interdisciplinary patient, seeing is
believing. " As orthodontists, it's generally pretty
easy for us to visualize how teeth need to move
in order to facilitate future restorative treatment
or implant placement. Where I think we
occasionally fail is when we mistakenly assume
that our patients also have this learned ability of
believing without seeing. Therefore, we have to
be careful not to assume that our patients always
understand what we say, especially when we are
so used to using our hands to illustrate proper
overbite and changes in anterior tooth position.
Dr. Patrick Turley (PT): What do you mean by
" establishing value " for a patient?
VK: It's basically the idea of helping patients
understand the importance of orthodontics as
structural in achieving their ultimate goal of ideal
function and esthetics. This can be quite challenging,
especially for the interdisciplinary patient,
since the level of importance placed on establishing
value in these patients is even higher.
PT: Why is it more difficult for the interdisciplinary
patient?
VK: When you think about it, our first job when
treating these patients happens even before we
actually start treating them and may be the most
difficult one we will face during their treatment:
trying to convince them that enduring the next
two to three years of orthodontic treatment,
which they never wanted in the first place, is essential
to the future success of their final restorative
treatment. I say that a bit tongue-in-cheek,
but it's true. The vast majority of adult patients
are not in our offices because of what they want
but because they have a basic understanding
of what they need. I guess the " glass half full "
perspective on this would be that they've learned
enough from the referring dentist or specialist
to get them through the door. However, this is
where the real work of " establishing value " begins
and we transform from clinician to educator.
PT: How do you establish value for the interdisciplinary
patient?
VK: I frequently use the analogy of building a
house: the orthodontics is the foundation that
the rest of the restorative house will be built on.
For the more simple, ortho-restorative cases that
involve primarily incisal wear and supra-eruption,
this technique works quite well. I think this is
because it's easier for patients to wrap their head
around the process of intruding teeth to create
restorative space. However, it doesn't seem to
work as well for the more complex interdisciplinary
cases involving a very specifically choreographed
sequence of ortho, perio, and restorative
treatment. I have found that most patients
respond best to visual aids. Therefore, unless we
have alternative methods that allow patients to
visualize the end game, our chances of establishing
value for these will most likely be limited.
We've all experienced those moments during
an exam when you're reviewing a complicated
treatment plan with the patient and you see them
38
PCSO Bulletin Winter 2022
Pacific Coast Society of Orthodontists Bulletin Winter 2022

Table of Contents for the Digital Edition of Pacific Coast Society of Orthodontists Bulletin Winter 2022
