State of the Profession: A Reflection

U.S. News And World Report once again ranked the Orthodontic Profession among the top 5 Best Jobs, recognizing great jobs as ones that challenge us, are a good match for our talents and skills, pay well, aren’t too stressful, offer room to advance and provide a satisfying work-life balance.  The ability to remedy dental health problems while building meaningful relationships with our patients certainly affords us a gratifying career.  Whether a new graduate, an orthodontist who has reached retirement, or someone in the middle of their career, we hope this to be true.  Over the course of 2017 each of our six NESO eNews publications features a State of the Profession as depicted by a NESO Alumni in each decade of life (30’s-80’s).  We’ve asked our Alumni to share some of their personal background and experience to shed light on how the profession has evolved, offer explanation of the changes that have occurred, outline how the responsibilities of an orthodontist vary over the course of one’s career and offer a projection of where our top-ranked profession is headed.

Our previous eNews publications have featured Dr. Ron Cortese (80’s) of Rochester, NY, Dr. Richard Reed (70’s) of Burlington, VT and Dr. Ron Bellohusen (60’s) of Elmira, NY.  This months publication we feature Dr. Carolyn Melita (50’s) of Belmont, MA.

Dr. Carolyn Melita received her undergraduate degree in Biology from the State University of New York at Albany.  She attended dental school at the University at Buffalo School of Dental Medicine where she graduated first in her class and then completed the orthodontic specialty program at the University of Connecticut School of Dental Medicine.  She has been practicing orthodontics since 1989 and throughout her career has been very active as a leader in organized dentistry.  She is a past president of the Massachusetts Association of Orthodontics and is our current Northeastern Society of Orthodontics President.  Outside of the office she enjoys running, biking, hiking and spending time with her wonderful family.

State of the Profession: Through 


The Loupes of Dr. Carolyn Melita

When people ask me how long I’ve been in practice and I answer “28 years” it astounds me. How is that possible? It seems like just a few short years ago I was toiling away in the University of Connecticut Orthodontic clinic. It was my privilege to be taught by the late Dr. Charles Burstone as well as Dr. Ravi Nanda and a very young Dr. Rohit Sachdeva. These luminaries in orthodontics provided us with a rigorous education. Almost all cases were treated with segmented mechanics. En masse retraction with composite T-loops with anti-rotation bends were de rigueur. I could diagram moments and forces. By the time I graduated from the program, I actually understood the biomechanics of orthodontics and yet, I was still not completely prepared for orthodontic practice in the “real world”.

I had the good fortune to join the practice of Dr. Mort Speck in Belmont, Massachusetts. At that time, Dr. Speck had been in practice for over 30 years and was a clinical instructor in the Harvard University Graduate Orthodontic program. Dr. Speck was a great teacher. He was also a “Begger.” Coming from a program rooted in the segmented technique, I had never even seen a Begg bracket. Needless to say, my education continued.  Over time we transitioned to the Tip-Edge bracket, a Begg derivative. Eventually, I progressed to a more conventional continuous edge-wise technique with pre-adjusted brackets. Even that was a leap for me as I had not treated many cases in my residency with continuous arch wires. I could hardly have imagined that one day I would be using a bracket that required no ligatures at all.

The evolution of the orthodontic bracket is just one of the many profound technological changes that have occurred in orthodontics over the course of my career. Digital radiography, aligner therapy, temporary anchorage devices, accelerated orthodontics, 3-D printing and my personal favorite, the intra-oral scanner, have all contributed to reducing treatment time and improving the overall patient experience.

In my opinion, no bigger change has occurred in the orthodontic profession over the past ten years than the commoditization of orthodontic treatment. With the great recession of 2008 came a dramatic increase in “shopping”. No longer do patients accept the recommendation of their general dentist to see a particular orthodontist. Patients are routinely having two or three orthodontic consults prior to choosing an orthodontist. Potential patients are relying more heavily on the opinions of others through the use of social media and online reviews when selecting an orthodontist.

Direct-to-consumer marketing also increased dramatically during this time. Patients began seeking particular treatment modalities; clear aligners primarily, self-ligating brackets to a lesser extent, and more recently, accelerated treatment. All of these changes have had a tremendous impact on how we market and operate our practices. Nonetheless, I believe our profession remains one of the best, and our future is bright.

Throughout my career, I’ve had the opportunity to become involved in organized dentistry in many different ways. It wasn’t something I had thought a lot about doing. Somebody simply asked me to do something and I said yes. Early on, I served on the membership committee of the Massachusetts Dental Society. A bit later, I became involved and served on the board of the Massachusetts Association of Orthodontists, eventually serving as president. And sometime in my early forties, I was invited to serve on a NESO annual meeting planning committee by Dr. Jack Kacewicz. That was the beginning of many years of very rewarding involvement with NESO and the AAO. I’ve served as a NESO board member, a delegate to the HOD, a member of the AAO Council on Orthodontic Practice and finally accepted the nomination to begin the climb up the officer ladder to the NESO presidency, where I find myself today. I am so grateful for these experiences and even more grateful for the friendships I have developed along the way.

As I head toward the culmination of this presidential year, I am excited for the future of our profession and our organization. There are many young, ambitious, talented orthodontists who have stepped up to become involved in NESO and the AAO. I urge any who are interested in getting involved to reach out to me or speak with any NESO board member. I hope to see many of you at our annual meeting in Boston!