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Episode #319: The Future Foundation of Orthodontics, with Dr. Drew McDonald

the best practices show podcast Jul 16, 2021

Orthodontics is more than just straightening teeth. And today’s guest, Dr. Drew McDonald, explains how foundational knowledge of patients’ issues can lead to more successful treatment and happier patients. Kirk Behrendt and Dr. McDonald talk about the interconnectedness of airway and joints in ortho and how interdisciplinary understanding can help patients long term. Don't be led astray by the esthetic side of things! For more on the importance of foundations, listen to Episode 319 of The Best Practices Show!

Main Takeaways:

  • Look under the surface — the foundation — in patients’ issues.
  • Airway and jaw joints influence structure, which leads patients into the ortho chair.
  • Ortho is more than straightening patients’ teeth.
  • Don't get lost in the esthetic side of things. Straight, white teeth isn't the endgame.
  • Understand who’s in your chair so you can give them the best treatment.


  • “As an orthodontist, we see patients with teeth that don't fit together, teeth that are crowded, whatever it might be. But at the end of the day, when we start peeling back the layers, we’ve got to know where that came from. And what we’re starting to understand, it seems like more and more every day, is that the airway side of things, the TMJ side of things, the growth and development, that those two factors, especially, really influence and create an orthodontic patient. Somebody with a bad bite and bad teeth, under the surface, there's an airway issue, or a joint issue, or both, a lot of the times.” (06:09—06:41)
  • “If we understand the foundation of our patients from a joint standpoint, from an airway standpoint, from even cervical, spine things, and the bone around their teeth, then we know what's going to be successful and stable long term because we’re addressing the under-the-surface things that got the patient into our chair.” (11:45—12:03)
  • “The other nightmare of orthodontists is relapse. So, if we can understand the foundation of our patients and what got them, under the surface, into our orthodontic chair, then we set ourselves up for better success, stability, and ultimately, a happier patient.” (12:34—12:48)
  • “Whenever I, quite honestly, wanted to be an orthodontist, I wasn't thinking about jaw joints or airway stuff. And some of that wasn't really a big part of what we were taught in school. And ultimately, I've gotten to know a lot of very influential people in my life who have taught me so much about the foundational side of joints, of airway. Dr. Mark Piper, he’s a big role model of mine. Jim McKee, in terms of the joints. They're not orthodontists. Those dudes, they put something in my head that did not come from orthodontic residency. But as I went back to patients after seeing them talk, I go, ‘This is my everyday patient. All of these Class II patients that all have clicks and pops, that's no coincidence.’” (13:26—14:15)
  • “The things that can lead orthodontists astray is that we start thinking about the cosmetic side, the esthetics, that that's all the endgame is for these patients.” (16:48—16:56)
  • “I think it’s easy in ortho, sadly, at this point in the game, to get led astray. And I will say, it’s a frustration of mine to see — and I'm not saying anything negative of the people that you see all over certain social media stuff. I'm just saying we have a better story to tell. And I think that the story to tell is that we can do more than straight teeth. It’s, we are the people most equipped to do more than straight teeth, and recognize it, and help people structurally.” (17:21—17:47)
  • “You can't just diagnose something and tell somebody they need to do something. You have to be able to motivate them. And ultimately, you have to know why that person’s in the chair too.” (19:50—20:00)
  • “I really do think that our place in the world as orthodontists is going to be involved in multidisciplinary health-related things. And again, I know that the flash is there right now of the smiles and all of that. And yes, we do that, and we’re the best at it because we know how to move teeth. We understand how to put teeth together. But wouldn't it be a good idea to put them together in the right spot, with the right airway, with the right joints, with everything else?” (31:04—31:33)
  • “The foundational issues, if we know and embrace them as orthodontists and become specialists in the things that are really under the surface, then we open up so many new avenues to take care of patients.” (33:13—33:25)
  • “We are equipped for this. We know how to move teeth. We know how to set up orthognathic surgery cases. We know how to get bites where they should be. And we essentially do a full-mouth rehabilitation on patients with natural teeth every day as an orthodontist. That's exactly what an ortho patient is. And if we set them up for success for what we do for them at 12, 13, 14, or even younger when we’re intercepting these things, we’ve done a way better service for our patients than just straight teeth.” (33:28—33:56)


  • Dr. McDonald’s background. (03:41—05:00)
  • Why this has become important in dentistry. (05:43—08:01)
  • Looking under the surface in patients’ issues. (08:24—12:48)
  • Rethinking how treatment gets done right. (13:21—15:09)
  • It’s easy to drift from the foundation. (15:45—18:58)
  • Understand who’s in your chair. (19:40—21:20)
  • How to differentiate yourself. (23:00—26:29)
  • Advice for younger dentists. (26:56—30:35)
  • The future of orthodontics is foundational. (31:03—34:21)
  • Dr. McDonald’s contact information. (35:14—39:14)

Reach Out to Dr. McDonald:

Dr. McDonald’s Instagram: @drdrewmcdonald https://www.instagram.com/drdrewmcdonald/?hl=en

Dr. McDonald’s website: https://www.mcdonaldortho.com/

Dr. McDonald’s Facebook: https://www.facebook.com/drew.mcdonald.984

Dr. Drew McDonald Bio:

Dr. Drew McDonald is a board-certified orthodontic specialist with a strong focus on airway and temporomandibular joint-focused treatment planning, surgically facilitated orthodontic treatment, and providing complex interdisciplinary care for patients. He lectures internationally on these topics and has contributed to literature and textbooks in these areas. Dr. McDonald is dedicated to advancing the profession of orthodontics and dentistry as a whole.

Born and raised in Tucson, Arizona, Dr. McDonald’s love of baseball brought him to Albuquerque, where he played as a catcher for the Lobos from 2006 to 2008. While attending the University of New Mexico, he met his wife, Emily, a New Mexico native. He also fell in love with the Sandias, green chile, and the near-perfect weather. He graduated from the University of New Mexico in 2008 with a Bachelor of Science degree in biology and a minor in chemistry.

Dr. McDonald attended dental school at the prestigious Creighton University in Omaha, Nebraska. Known for its rigorous academic curriculum and intense clinical training, Dr. McDonald received many academic accolades while at Creighton, including inductions into Omicron Kappa Upsilon (National Dental Honor Society) and Alpha Sigma Nu (Honor Society of Jesuit Universities). He also served in leadership positions as class president and student body president, and on alumni relations committees.

After graduating cum laude from Creighton, Dr. McDonald was accepted as one of only three residents nationwide into the University of Missouri-Kansas City Orthodontics program, a renowned two-and-a-half-year, full-time residency known for its clinical excellence. Dr. McDonald graduated in December of 2016 with his certificate in orthodontics and master’s degree in Oral and Craniofacial Sciences.

When away from the office, Dr. Drew is a “girl-Dad” to two daughters, a self-proclaimed grill master, and minimally talented yet enthusiastic golfer. You can find him taking in a Lobos game and spending time outdoors with his family. 


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