Interview with Dr. Greenfield – Non extraction technique

  1. CephX | AI Driven Dental Services

Dr. Greenfield is the author of “Nonextraction Orthodontics, 98.5% Nonextraction Therapy using Coordinated Arch Development®“, a textbook that has been published in four different languages, and is now in its 2nd edition, with over 1,100 pages and 7,000 images.

During the making of his textbook Dr. Greenfield made extensive use of services to get unbiased Cephalometric analyses, and through that we came to learn about his 98.5% nonextraction treatment philosophy entitled; “Coordinated Arch Development®.”


Dr. Greenfield was invited to present his philosophy at the 1996, 2003, 2004 and 2005 scientific sessions of the American Association of Orthodontics, and was asked to defend his Nonextraction approach at numerous sessions, including:

  • The 1992 and 2002 College of Diplomates of the American Board of Orthodontics annual sessions
  • The 1993 Southern Association of Orthodontists’ annual session
  • The 1998 Northeastern Society of Orthodontists’ annual meeting
  • The 1999 American Academy of Pediatric Dentistry annual session
  • The 2001 Japanese Orthodontic Society Annual session.



Let’s start with your background information

I am a graduate with honors from Howard University College of Dentistry in 1971.  After receiving my Master of Science in Orthodontics from Boston University in 1973, I continued as a Clinical Instructor until 1976.  In 1984 I became a Diplomate of the American Board of Orthodontics and was invited to exhibit my board cases at the A.A.O. meeting that same year.

How and when did you develop your NON-extraction technique?

“Coordinated Arch Development®“ is a nonextraction philosophy more than a technique.   Its roots were formed in the early 1940’s from the work of my mentor Dr. Norman Cetlin, arguably one of the greatest orthodontic clinicians in the modern era.  The Tweed extraction philosophy was very popular at the time and consequently Cetlin’s early efforts were overshadowed.   In the 1970’s and 1980’s, long term nonextraction cases were exhibited at the AAO meetings which aroused great interest in the philosophy. Cases 25 years out of retention were also submitted to the University of Michigan for evaluation of the technique’s long term stability.

Please explain “Coordinated Arch Development®” philosophy

Achieving long term stability requires controlled upper and lower 1st molar movements, simultaneously, in all three planes.  Light continuous forces of similar magnitude are utilized to “coordinate” these movements.  The final orientation of the molars creates occlusal forces through the long axes with the absence of deflective contacts during function.  The molars are placed well within cancellous bone and the “neutral zone” to enhance their compatibility with the periodontium and soft tissue envelope.  The resultant position of the anterior segment provides proper incisal guidance and maximizes facial and dental aesthetics. nextortho-sample1
nextortho-sample3 nextortho-sample2a

What has changed in the industry since the book was written?

The pendulum has definitely swung towards a nonextraction treatment approach the last several years.   People want a full radiant smile rather than seeing dark corridors at the corners of a smile.   However, there is high quality nonextraction treatment and there is quick nonextraction treatment.   The new generation of orthodontists must lean towards quality in this delicate balance.   The Doctor must remember that the treatment decisions they make today will impact the patient’s health for the rest of their life.   Throughout the Textbook, the principles for attaining long term stability for their patients are explained in vivid detail, and must never be compromised for the sake of “efficiency.”

What can you tell us about the book writing process?

The writing of the Textbook took approximately 4 years.   Without the encouragement of my wife, the project would never have been completed.   She typed and proof read the entire manuscript while I compiled long term records on my patients.  In fact, my youngest daughter whose a graphic artist, designed the cover – it truly was a family effort.   I had 3 contributing editors write 3 chapters in the textbook, and CephX , under the expert direction of Danny Abraham, traced every cephalometric x-ray in the textbook.  CephX unbiased data not only made my job easier, but it contributed greatly to the success of the publication.   We also included 10 cases  from my study club in Japan.   I specifically chose Japanese cases since they are considered to be among the most difficult nonextraction cases in the world.  It was my way of confirming the versatility of this philosophy no matter how difficult the case. nextortho

When and where was the book distributed thus far?

The textbook has been published in four different languages, and is distributed throughout the world. It is available in hard copy (Amazon), and in digital (Downloadable) format.  The information contained in the Textbook is NOT available anywhere else, so Doctors that have purchased the Textbook are very appreciative of its content.  I constantly receive hundreds of emails from Doctors around the world thanking me for sharing this information – it has prevented the unnecessary extraction of teeth in thousands of children and adults.

My ultimate goal is to create optimum LONG TERM function and radiant smiles for our patients worldwide.

Can you share with us feedback you received about it?

The feedback has been extremely positive – beyond my wildest imagination.  Doctors have emailed me thousands of photos of their cases treated successfully with the information contained within the textbook.   Many Doctors wished they had this knowledge earlier in their career.  In fact, my Japanese study club recently won 1st place for their case presentation at the American Association of Orthodontists Annual session.

Do you plan to publish a follow up book to extend the technique?

The textbook is now in its 2nd edition and still very popular.   The Chinese publication has just been released in December, 2015.

Instead of publishing a 3rd edition, we have now expanded our FREE WEBSITE, NEXTORTHO.COM to include VIDEOS of all the techniques in the textbook, and 100 nonextraction cases illustrated in vivid detail in our “library of cases.”  By making the website FREE, we have made the “Coordinated Arch Development®” nonextraction philosophy accessible to students and clinicians in every country.   This will expedite my goal of preventing unnecessary extractions in children worldwide.

How do you feel about CephX – how relevant is the online tool for the industry – what is the added value you see in Cephx to the industry

The value of CephX to me as a clinician, author and researcher is extremely valuable for different reasons.   First, it removes all bias from my cephalometric measurements.   This is very important in the minds of Doctors who purchase my Textbook.  If I traced the X-ray, they may be concerned that the measurements were skewed in my favor.

The tracings are performed by a well-trained 3rd party who does it all day long.   Thus the quality of the tracings and measurements are consistently excellent.   Our diagnoses & treatment plans are certainly enhanced by their quality & consistency.

CephX has all the popular cephalometric analyses on their website.   Therefore, the Doctor can refer to any of the analyses for a specific measurement to aid his diagnosis – how important is that!   In fact, Doctors who purchased my textbook were allowed to contact CephX to gain access to any of my case measurements if they wanted to view their favorite analysis online.   Finally, I cannot say enough about the excellent support of CephX I received for the past 15 years.   Anytime there was an issue, it was resolved the same day in a courteous and professional manner via email.

The Doctor does not have to train a staff member to perform this task, nor train another staff member should the original employee leave the office.   This is a real time saver in a busy office.

An author or researcher can focus on their research rather than worry about the accuracy of their tracings.   Placing this task in the hands of an expert improves the overall quality of the final product.

Finally, CephX may not have invented cephalometric tracing, but CephX certainly defines it.

Dr. Greenfield’s textbook is available at

CephX online cephalometric trace & analysis is available at

For more information please contact or 1-800-992-1499

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How do patients choose their Orthodontist

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Choosing an orthodontist carries great responsibility, as it has a very clear effect on a person’s aesthetics and health. The majority of orthodontic patients are children, leaving the responsibility on parents to choose the right caregiver and treatment type. This task is taken very seriously, and followed by weeks of research.

In this article, we have gathered the considerations that help parents and patients in general make up the final decision – who to choose as their Orthodontist.


Awareness and knowledge – of the treatment’s importance, orthodontist’s existence

Acknowledgement of orthodontists and their expertise is a vital first step. A patient must distinguish between a dentist’s role and an orthodontist’s role, while choosing whom to approach for treatment.

Awareness can be achieved through schools and teachers, family physicians, governmental programs and the media.

Need and Treatment Motivation

Today, aesthetics is very important. Our role models showcase perfect smiles in the media and we want our kids and ourselves to have that too. In addition, there is also the element of healthcare when it comes to orthodontics (sleep disorders, painful teeth misalignment).

The patient’s need has to be there, either from the healthcare or aesthetics sides, in order to turn to a specialist. If the problem isn’t troubling enough, the condition may be left untreated.

Credibility, References and Trust – of the Practice and Orthodontist

Education is part of the credibility Orthodontists have. Patients normally check their physician’s education, and certification, while also want to ensure they are a Board Certified. This demonstrates a higher commitment and dedication, given the standards requirements.

References (recommendations by experienced friends) are also an important element patients look for. Word-of-mouth, recommendation, testimonials all act as great reference for a patient.

Technologically Equipped Clinic

People expect to receive leading treatment and to also fully understand it. The technology is available through improved software, larger screens, full images, laser innovations, advanced treatment materials, online Cephalometric analysis…etc. Orthodontists willing to ensure their clinic is staffed with leading technology and able to showcase it, are more likely to gain the customer.

Personal Connection

Trusting the doctor from an education perspective isn’t enough – if the personal connection isn’t there. Each patient looks for an assuring and easy-going caregiver, who is willing to listen to their questions, concerns and fears. Many doctors today may be very well educated, with lots of experience, but are less attentive to the emotional side of the treatment.  In situations as such, the patient will prefer to seek a different doctor, especially if there is a larger choice available nearby.

Affordable Costs & Payments

Affordable treatment prices are an important part of the patient’s decision making process, however it’s normally mentioned after overcoming the barriers mentioned earlier. It’s vital for the patient to first check their treatment type, and only then find out if they can afford it, considering various payment/finance options.

Many practices provide different payment terms, specifically since the actual orthodontic care is normally spread out through several months or even years.

Availability and Location

A treatment plan may be laid out over months and years, which is why patients tend to also choose their orthodontist according to the practice’s location and ease of travel.  Ensuring they can make the appointments, without loosing too much work or school days, due to traffic or parking issues is  important.


Every Orthodontist can play a major role in every single part of the listed items. Awareness creation, motivation, market education

  • Marketing plan – Maintain an online and social marketing plan, as that’s where most Patients start their research nowadays! Be sure to be listed on local/online directories, community organizations, healthcare programs.
  • Keep up to date – with new technologies, innovations, and treatment types. This will ensure your market competitiveness positioning.
  • Have your references, case studies, education easy to find. These can be publicized on the web, social media channels, and reviews by local/national magazines.
  • Make sure you choose a friendly staff with a welcoming and warm attitude.
  • Give back to the community – It’s always great to provide some pro-bono help. The community appreciates it, and increases your clinic’s credibility
  • Be ready for lots of questions, even if they sound repetitious or obvious.
  • Position your clinic in a good location, with good access to public transportation and parking.
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and Orthodontic Trends in 2015

Orthodontics – 2015 Summary

  1. CephX | AI Driven Dental Services

2016 already started, holding promises for another year of growth in the fields of dentistry and orthodontics. But it’s always important to look back to get an overview of trends and changes in the business, and conclude insights that may help us down the road.


According to a survey conducted in the USA on 2015, Orthodontists spend a weekly average of 30-40 hours  with patients This does not include time spent on practice management, staff recruitment and training, marketing and general business management, which most of it can outsourced.


The demand for orthodontics in the USA is comparatively higher than the rest of the world.
According to the WFO (World Federation of Orthodontists), in 2015 the number of orthodontist in USA is over 9,000. The European countries have additional 10,000 orthodontists (500 in Belgium, 350 in Czech, 200 in Denmark, 150 in Finland, 2500 in France, 3000 in Germany, 450 in Greece, 150 in Ireland, 1300 in Italy, 250 in Norway, 1100 in Poland, 300 in Sweden, 300 in Netherlands, and 1,200 in the UK). Due to lack of oral health awareness, lack of literacy, poor economic condition the demand for orthodontics in Asia is significantly lower compared to the rest of the world. Market research shows that only 1,500 orthodontists are working around Asia, leading to a low ratio to the large Asian population.


History demonstrates that during the past couple of decades it was normally children and teenagers were the main target patients of orthodontics. But now in 2015, this situation has changed for adult population – significantly more are concerned with correcting or improving the position of their teeth and correcting any malocclusion.

Recent study shows that over 1 million North Americans are taking orthodontics treatment by wearing braces in present days.


The way forward for orthodontics is challenging yet promising bright. Challenges are primarily characterized with barriers for new entry, lack of awareness to new techniques and high cost of advanced treatments. For emerging markets, mainly around Asia, increasing demand for orthodontics is held back by less professional, with many of registered ones actually working in governmental hospitals.

Nevertheless, the bright future of Orthodontics is driven by new era of dental science, mainly clear aligners, rising dental aesthetic standards, rapid GDP growth in Asian markets and new technologies enabling less manpower for running Orthodontic practice, such as cloud services.Despite of greater competition, higher patient expectations, and increased legislative involvements, 5 years from now expect to see an increased usage trend of digital orthodontics including Laser technology, x-rays, White light, 3D printing, Intraoral Scanners, and Digital Photography which is expected to have the market size around $3.6 billion in the global dental market


Are you ready to attain excellence to brace yourselves for 2016?

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