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Part 1: Leadership Orientation Overview

As a component or constituent leader, you likely have a general idea about what the association is and how it works. But you may have had more specific questions about how decisions get made and how recommendations are considered by the Board of Trustees and/or House of Delegates and then acted upon. In other words, how does stuff get done? Who works behind the scenes to make sure the organization stays vibrant and relevant? Those questions are answered here. Let’s start with some basics. The AAO is:

  • A professional, not-for-profit association incorporated in St. Louis, Missouri.
  • A representative organization founded in 1900. Since then, membership has grown to nearly 19,000 members throughout the United States, Canada and abroad.
  • Comprised of members who are educationally qualified orthodontic specialists.
Mission and Purpose           *If you need a reminder, click the link to the left to check out the AAO mission and purpose.

AAO Leadership

The Board of Trustees and House of Delegates make decisions that set direction for the organization. Each entity has different responsibilities as shown, but each governs the AAO by setting policy and overseeing different functions of the organization: strategy, finances, membership, advocacy, etc. They also rely on advisory groups of members – councils and committees – to work on specific projects or oversee certain functions like membership or scientific affairs.

Staff advise the BOT and HOD and implement the projects and programs that they authorize. The executive director is the chief staff member responsible for the general management of the AAO and reports to the Board of Trustees.  Responsibilities include:
  • representing the association to external stakeholders such as other industry associations, customer groups, suppliers and the general public;
  • developing and executing strategic initiatives for the association;
  •  leading all association communication efforts, both internal and external, to ensure that the association and the industry are perceived in a positive manner by all stakeholders, and that association objectives are accomplished;
  • managing all association activities and ensuring that activities are properly conducted, reported and accounted for to the Board of Directors and House of Delegates.


The process of governing – governance – occurs through deliberation and discussion with input from members. Before decisions are made, feedback is collected in different ways such as through surveys, peer-to-peer conversations and online discussion forums. The BOT and HOD use that feedback when they meet to discuss issues.
Discussions in the HOD occur in formal meetings where 64 delegates debate and vote on proposals called resolutions. Like any large, formal body, certain procedures guide the process of deliberation. The speaker of the HOD serves as the chair of the meetings and relies on guidance from a professional parliamentarian and staff to administer the work of the HOD. The HOD meets annually concurrent with the AAO Annual Session and also meets in at least one virtual meeting each year.
The HOD has the authority to set policy for the AAO. It represents the membership through eight constituents and makes decisions about the AAO and the specialty. Specifically, the HOD approves dues, the annual operating budget and the strategic plan, among other items. Delegates represent the constituents, allotted in proportion to the total membership size of each constituent. These delegates review the issues before the HOD and then vote on them. Before the HOD meets as a whole, delegates meet in smaller caucus meetings where they can raise questions, determine positions or identify amendments. Delegates vote on each issue once the HOD convenes as a large governing body.
To learn more about the role of delegates and the importance of member participation in our governance, check out these brief video interviews and podcast.
  • Former Speaker of the House Michael Foy and Current Speaker Jeff Rickabaugh – This interview features the current and incoming Speakers of the House of Delegates as they describe the HOD and their experiences as AAO leaders.
  • Governance Overview Podcast – In this audio-only interview, Kevin Dillard, AAO’s former General Counsel, discusses the importance of affiliation agreements, as well as fiduciary duties. Roger Hanshaw, AAO Parliamentarian, describes common misperceptions about parliamentary procedure and keys to running a successful business meeting.
The HOD has the authority to set policy for the AAO. It represents the membership through eight constituents and makes decisions about the AAO and the specialty. Specifically, the HOD approves dues, the annual operating budget and the strategic plan.
The BOT is a smaller group of 12 individuals who meet in less formal, frequent meetings throughout the year.
Delegates and BOT members are selected to represent the needs of the membership as they consider different proposals and actions. To understand how they are selected, you need to understand more about the AAO structure described in the following sections. Being a large organization, the AAO relies on smaller local entities to execute certain activities including the nomination of members for certain leadership positions.


The AAO is a not-for-profit association, and it operates differently than a for-profit corporation. While both can and do earn profits, they are recognized and treated differently under federal tax regulations. More importantly, an association is unique in regard to the role that members play in leading and influencing the organization. Members are both owners and customers of the association. Dues are like equity, making members shareholders of the organization. And like a customer, members may choose to purchase certain products or services like event registrations.
Further, some members are leaders of the organization in their service as board or committee members.  In a for-profit model, customers are not necessarily shareholders or leaders of the organization.
Typically, members belong to the AAO nationally and to smaller regional and local organizations. These organizations are called constituent and component societies. International members do not belong to components and constituents, however, since they do not have ready access to them.


Constituents are regional, chartered organizations of the AAO, located within the United States and Canada. At the regional level, constituent organizations support, assist, and participate with the AAO and the components within its jurisdiction to achieve a common purpose dedicated to the advancement of orthodontics. There are eight constituents:

  • Great Lakes Association (GLAO)
  • Middle Atlantic Society (MASO)
  • Midwestern Society (MSO)
  • Northeastern Society (NESO)
  • Pacific Coast Society (PSCO)
  • Rocky Mountain Society (RMSO)
  • Southern Association (SAO)
  • Southwestern Society (SWSO)

Constituent organizations have boards of directors who govern the organization. Constituents have their own dues and/or assessments that are separate from the AAO’s, and these regional organizations also rely on committees to develop their own programs and services independent of the AAO’s. Constituents select representatives – delegates — to attend meetings of the AAO House of Delegates. In this way, each constituent helps shape AAO policy and strategic direction.

Each constituent nominates a member to serve as a trustee on the AAO BOT. Each trustee is nominated with the understanding that s/he will eventually serve as AAO president assuming s/he chooses to remain on the BOT and fulfill his/her responsibilities.

In addition, each constituent nominates members to serve on certain councils and as delegates in the HOD. With the authority to make nominations, constituents strongly influence the direction of the AAO.


Components are state and province-based societies within each constituent. At the state or province level, components pursue and advance the principles and purposes of their respective constituents as well as the AAO.
Each component has its own board of directors. They may choose to employ staff, volunteers or a combination of both to administer and manage the organization.  Like constituents, components may appoint standing or ad hoc committees to perform certain duties. Members who serve as volunteers at the component level often gain experience that can be applied at the constituent and national levels of service within the AAO.

Councils & Committees

Councils and committees are smaller groups that advise the BOT and HOD. They recommend actions or ideas for consideration. Each constituent nominates members to serve on councils. A term is two years, and a member is eligible to serve for three terms. To take a closer look at the role of councils in the AAO, please review the 2019 Council Orientation presentation slides or view the recorded, downloadable webinar.

Strategic Plan

The strategic plan lays out a plan of action around critical issues that go beyond routine operations. The plan includes goals and actions to meet them. To learn more about the strategic plan, click here.

Effective May 7, 2018, the House of Delegates (HOD) approved a new strategic plan. This plan reflects the diversity of thought and perspectives of a large committee of members who represented different facets of the specialty and of the association. This committee, the Global Strategic Planning Committtee, represented delegate chairs, councils, constituents, vendors, manufacturers, industry consultants and new/younger members. Following a review of research and discussions about the state of the specialty and the AAO, the committee created a strategy map that reflected several changes:

  • Revised mission and vision statements
  • Explicitly stated core values
  • New goals and objectives
  • New strategic initiatives, which are the priority areas that the AAO will focus on to achieve the goals in the plan.