The Rose of Time: A Conversation with Spanish Orthodontic Professor Dr. Leon Valencia

Foreword

Dr. Leon Valencia noticed that his one-and-a-half-year-old child was still using a pacifier, and the mandible had already shown signs of open bite. At that moment, he was first a father, then an orthodontist. A week later, he and his family decided to stop the pacifier.

Behind this decision lies a bigger question: when to intervene, and when to wait.

This is not just his dilemma. The "2025 China Children's Early Orthodontic Trend Report" released by Angelalign shows that the exposure of "mixed dentition correction" on Xiaohongshu platform has increased by 1465.4% over the past year—a new generation of parents are asking the same question with unprecedented attention.

*Source: GoodNews Video Account

When this Madrid-based professor, recognized by many international peers in the field of digital orthodontics, talks about this moment, his tone is light. In his view, these seemingly daily parenting decisions all point to the same question: What is "the right timing".

From obtaining his dental degree in 2004 to focusing on orthodontics since 2009, Dr. Leon Valencia has witnessed the complete transformation of orthodontics from plaster models and manual wire bending to digital design and CBCT three-dimensional imaging. "I'm right in the middle between traditional manual (analog) and the digital generation." His daily cases mainly focus on adolescent and adult orthodontics, and in recent years he has invested more energy in children's early oral prevention and treatment.

This is also his fourth visit to China this year. Four visits a year—the frequency itself is an answer. On this visit, at the invitation of GoodNews, this Spanish professor accepted an interview and talked with us about his understanding of time, timing, and predictability in clinical work.

The following:

Where Do Doctors' Time Go

Dr. Leon Valencia mentioned a study he recently read: doctors and nurses realize that most of their time is consumed by administrative work rather than patient treatment.

The clinic where he works now uses a simple automated system to remind patients of follow-ups, freeing up the time that used to be spent making phone calls all morning for doctors and nurses to use in clinical work and communication. In his view, the real value of digital tools is not about "how smart" they are, but about liberating limited time from administrative tasks.

Dr. Leon Valencia at work *Source: Clínica Dental

But administrative work is only the first layer of consumption. The more hidden time black hole comes from the supply chain.

"Waiting for the delivery time from the lab. Sometimes it's 5 days, sometimes a week, sometimes two weeks." This uncertainty disrupts the entire treatment rhythm. Traditional laboratory production of orthodontic appliance attachments typically takes 7-14 days; clear aligners have an even longer chain from design to production to logistics. Patients don't understand why they have to wait. They need to work, be with family, and every follow-up means taking time off, commuting, and waiting.

It is under this multiple squeeze that Dr. Leon Valencia has become particularly sensitive to "who really helps save time."

Four years ago, Dr. Leon Valencia switched his clear aligner partner brand. For a doctor who has used multiple systems and won the "Best Student Award" in the orthodontic master's program at the University of Alcalá, this was not an impulsive decision. He recalls encountering long feedback chains and insufficient attention to clinical details in some systems before.

*Source: Angelalign

The turning point that prompted him to make this decision was an online meeting more than four years ago. "The first time I saw Angelalign's software, I saw CBCT integration, angelButton, and various functions within the system." CBCT integration means being able to view three-dimensional images, overlay design plans, and evaluate root movement paths within the same system; angelButton is a completely new traction system released by Angelalign in June 2019, solving the technical difficulty of anchorage control in clear aligner treatment.

His immediate impression was: "For me, this wasn't just a product list, it was more like a group of designers trying to understand the problems we encounter in the clinic."

Daily collaboration verified this judgment. In the current cooperation model, he can usually receive a new batch of aligners in about a week, and this response speed allows him to be more confident when arranging follow-ups and communicating expectations. As cases accumulate, he feels that the design team's understanding of his preferences is gradually deepening, and now design plans usually only need minor adjustments before entering the clinical stage.

*Source: GoodNews Video Account

In his clinical experience, most routine cases, if the treatment strategy is appropriate, can usually be completed within 18-24 months. His personal requirement for his cases is: "No matter what aligner we use, we try to complete treatment within two years."

As cooperation time increases, Dr. Leon Valencia's trust in this system has risen from personal experience to recognition of the entire supply chain. The data from Angelalign's 2025 interim report seems to also verify the scalable replication of this efficiency advantage: its global market clear aligner cases reached approximately 117,200, a year-on-year increase of 103.5%. In his view, behind such growth speed is the systematic optimization of supply chain efficiency, design response speed, and doctor-patient communication costs.

But efficiency is just the starting point. The more difficult question is timing.

The Timing of the First Tooth

That decision about his child made Dr. Leon Valencia begin to re-examine the value of early assessment. His view is: "The first assessment can start from the eruption of the first tooth, along with an oral examination. Starting from around 1 year old is a suitable starting point for observing maxillofacial development and lifestyle habits, which does not mean orthodontic treatment needs to start at this time."

But he also emphasizes that even though he is already an orthodontist, he still needs to continuously learn about early oral and maxillofacial development in children. "I realized I wanted to know more, and I was worried—worried about my own child, and also worried that other parents don't know these things. We need to better educate parents, especially about prevention."

*Source: GoodNews Video Account

In many countries, media and professional organizations have warned of a common risk: "Early orthodontic treatment is not the earlier the better, and certainly not one-size-fits-all." What Dr. Leon Valencia emphasizes is not "doing more treatment as early as possible," but seeing the child's developmental trajectory as early as possible and doing the right thing at the right time.

This concept is supported by international research. The 1-year-old first assessment advocated by Dr. Leon Valencia is the starting point of preventive screening; the 7-year-old screening recommended by the American Association of Orthodontists is the time point for determining treatment plans. An Italian study showed that among 2,199 school children, the proportion truly needing intervention was 35.5%—this indicates that the significance of assessment is not to have every child receive treatment, but to identify children who truly need intervention.

*Source: "Early Orthodontic Treatment Needs in Children: A Prospective Observational Study on Italian School-Age Children"

In China, this issue appears even more urgent. The "Chinese Expert Consensus on Early Orthodontic Treatment of Malocclusion in Children" points out that malocclusion affects nearly 260 million children, and early orthodontic treatment under strict indications helps reduce the risk of malocclusion.

*Source: GoodNews Video Account

It is this emphasis on "early identification" that keeps Dr. Leon Valencia continuously attentive to developments in China's orthodontic field. His observation when talking about China is: "When I come to China, I realize there's a lot to learn. It's like when I was a child, trying to see something interesting, and then discovering there's more interesting things behind it." This curiosity comes from the rapid development he sees in China—whether it's the clinical application speed of digital technology or the overall innovation vitality of the industry, they all make him feel the breadth and depth worth exploring in depth.

The evolution of topics at China's annual orthodontic conferences may explain the source of this feeling. From 2021 to 2025, the discussion focus of early orthodontic treatment has undergone significant transformation: from evidence-based debates about "whether to do it" to technical implementation of "how to do it"—timing selection, aligner design, and digital tool application have become mainstream topics. Digital orthodontics and AI-assisted diagnosis have emerged intensively in the past two years, and the participation of international experts has become increasingly active. This acceleration from concept to practice often takes longer in other countries.

*Source: GoodNews DataLab

Four round trips a year are not only for sharing but also for learning—in this rapidly iterating field, maintaining continuous presence is the only way to truly understand the rhythm of change.

Dr. Leon Valencia attending the 2025 A-TECH Conference *Source: Angelalign

As an official instructor for Angelalign in Europe, he has been sharing the latest advances in digital orthodontics across Europe since 2023. This cross-border exchange allows him to understand both Europe's evidence-based medicine tradition and China's unique speed in clinical implementation of digital technology. In his view, this two-way learning itself is a practice of "right timing"—knowing when to learn from others and when to innovate.

Timing judgment requires evidence. Whether it's 1-year-old early assessment or every design step in adult cases, Dr. Leon Valencia is pursuing the same thing: making judgments with confidence.

Pursuing Certainty

For Dr. Leon Valencia, "timing judgment" doesn't only occur in early childhood assessment but runs through every design decision in adult cases—this makes his reliance on "predictability" stronger than many peers.

In his view, predictability is the key to judging whether a technology is mature—not "can teeth be moved," but "can they be moved to the expected position according to plan and within the safe range." This is why he invests a lot of energy in force design, anchorage methods, and imaging verification.

To pursue this certainty, Dr. Leon Valencia habitually uses CBCT to compare initial consultation and follow-up situations, to verify "the gap between plan and reality." In his view, this is closer to the actual position changes of tooth roots than simply looking at plaster models, and it better helps him determine the next step.

*Source: GoodNews Video Account

At the tool level, the emergence of new traction systems like angelButton has provided key support for his pursuit of predictability. When talking about this traction system released at the 6th A-TECH Conference in June 2019, he said: "For me personally, this type of tool has largely changed my design habits, almost like a 'game changer.'"

Before angelButton, the problem Valencia encountered was: "When you don't have proper anchorage, developing force design becomes complex." With reliable anchorage, he began trying tooth movement sequences he didn't dare design before—molar uprighting, impacted canine traction, precise root displacement. For different doctors, the usage and dependence on such tools will vary, but for him as an orthodontist handling a large number of complex movement cases, stable anchorage and controllable traction methods have significantly reduced his concerns in the design phase.

Predictability doesn't only occur at the endpoint of treatment but also at the starting point. The earlier one sees the developmental trajectory, the easier it is to predict how much treatment will be needed later. A German study showed that among children receiving early intervention, 87.1% no longer needed further orthodontic treatment after treatment ended. This confirms the value of seeing the developmental trajectory early.

*Source: "Evaluation of Dental Arch Width Expansion Using a Novel Virtual Bracket and Nickel-Titanium Archwire Hybrid Appliance: A Prospective Clinical Study"

But predictability comes at a cost. It requires doctors to spend time learning new technologies, repeatedly communicating with designers, and using CBCT to verify the actual effects of each case. During his doctoral studies at Complutense University, his research topic was "Efficiency and Effectiveness Evaluation of Hybrid Appliance Systems (Combining Virtual Brackets and Nickel-Titanium Archwires)"—this is at the forefront of current orthodontic digitalization research and is also a systematic summary of his more than twenty years of clinical experience.

In his clinic in Madrid, patients evaluate him as "one of the best orthodontists in Spain," "giving me back confidence in my smile." This trust comes from accurate grasp of timing and the predictability of each treatment outcome.

[Interviewer's Notes]

In recent years, Dr. Leon Valencia has traveled between different cities in Europe and Asia for lectures and consultations. These peers who use the same digital system with him are rarely doctors who only chase "new technology," but rather a group of people who have strong requirements for case quality, time costs, and predictability in their respective countries. In this sense, a company's global clinical network is also a kind of "screening result of time."

Dr. Leon Valencia's decision to stop his child's pacifier took only a week. But the timing judgment of this week was backed by years of accumulation. The brand choice four years ago has been verified by daily collaboration today. Four round trips a year are also answering with actions what kind of cooperation is worth continuous investment.

The 7 days of the supply chain, the 18 months of treatment, the first assessment at 1 year old—these numbers are all answering: when to be fast, when to be slow.

Orthodontics is a discipline about time. Tooth movement needs time, jaw growth needs time, and building doctor-patient trust needs time. Technology is evolving, but the grasp of timing, the pursuit of predictability, and respect for patients' time costs—these always constitute the most core part of medicine.

Time is a rose. It needs patient waiting and accurate judgment. Dr. Leon Valencia's more than twenty years of clinical accumulation let him know when to act and when to wait. This composure may be the gift given by time.