Innovations in orthodontics over last decade improve patient experience, outcomes

This story first appeared in Healthy You - November 2025, The Gazette’s quarterly health publication.

Over the last decade, advancements in the orthodontics field have offered practitioners more options in dealing with a variety of issues and have led to better patient outcomes and experiences.

Dr. Jason Schmit, with Parks, Schmit, & Fuller Orthodontics based in Cedar Rapids, has been practicing since 2000 and has had a front row seat as innovations have hit the industry. He also serves as an adjunct assistant professor of orthodontics at the University of Iowa, where he’s seeing the cutting-edge advancements for the next generation of orthodontists.

There are five major shifts Schmit said he and his colleagues have seen over the last 10 years.

The first innovation is a TAD, or temporary anchorage device. These mini screws are anchored into the jawbone to push and pull teeth in different directions, something not possible with traditional braces, Scmit said.

“One of the beauties with that is we sometimes now can prevent what used to be a jaw surgery case, or we can prevent extracting teeth in certain situations,” he said, also noting there are opportunities to help patients close gaps with missing teeth. “TADs allow us to do a lot more complex orthodontic treatments, which is great for patients and great for orthodontists. The residents coming out of school now are putting in TADS like they are doing a filling. It’s so commonplace now for practicing orthodontists.”

Another change over the last decade, Schmit said, is the prevalence of clear liners, or moving teeth without braces.

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“The word people will use would be Invisalign, which is just one of the many companies that makes clear liners,” he said. “Basically, it’s a clear plastic that incrementally will move teeth to the final position that we're wanting.”

Schmit said that when these liners first came out in the early 2000s, they were not very effective. However, in the last decade there have been huge strides thanks to innovations and competition in the market.

“While there are still significant limitations to what we can and can’t do versus braces, these continue to improve, and more and more cases can be treated this way,” he said.

A third innovative shift is computer assisted bracket positioning.

“Brackets are what go on each individual tooth, and together we call it braces,” Schmit said. “And it used to be that orthodontists would place braces directly on a tooth in the chair while the patient was in the office. But in our office, for at least the last 20 years, (we do) what’s called indirect bonding. We make a custom tray with braces that fit the teeth that slips on like a mouth guard, and then we adhere braces that way. That allows us to put the braces on a model outside of the mouth and you can be a little bit more accurate with where we place them.”

Now, a lot of this is done by computer so they can fine tune where the brackets are placed, including at the angle.

“All these things just allow us to get closer to the end result quicker, and it then allows us to really fine tune the positions of the teeth so we can do orthodontics better and faster. That means less time patients need to wear braces,” Schmit said.

The software continues to become more efficient, and he foresees a day when this will be the only way in which orthodontic braces are put on.

Technological advances are behind the last two innovations. Schmit noted their use of an intraural scanner is a big one. Instead of taking impressions with goopy stuff that had to set up in the mouth — a process most patients disliked — orthodontists can now use the scanner to take hundreds of photos of a patient’s mouth to create a detailed, three-dimensional image and model of the mouth.

“It’s really pretty cool and does it right in front of your face,” Schmit said. “We do it at our initial exam, and parents and patients are always wowed. It’s a great diagnostic tool to help us make a treatment plan.”

He said this leads to another innovation, the use of 3-D printing.

“We have three 3-D printers now, and we started printing about a year and a half ago.” Dr. Schmit said this is one area that is really going to continue to innovate.

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“We take the 3-D scan, make the 3-D model, and then we can make a retainer off of that, or we can do in-house aligners off of that like Invisalign.”

He said they also use the model for the indirect bonding where they put the braces on the physical model and then make a transfer tray to create custom braces for that individual.

“The printers are getting really, really good. A couple of ours print in just six minutes. That means in our office we've changed it now where we will take braces off, clean all the adhesive, and then while we're taking our final pictures and X-rays, the printer is printing out the model, and we'll actually give them retainers before they leave. So, it's a one-day thing versus coming back the next day,” Schmit said.

Plus, having the ability to print it quickly allows for easier retainer replacement if one gets lost.

Schmit said the innovations will continue to improve the way he and his colleagues can do their work, and ultimately, improve patient experiences and outcomes.

“The future of orthodontics is encouraging us to really be on the cutting edge,” he said.