Two things have happened that prompt me to write. The first was Dr. Meskin’s editorial regarding strength in numbers as a reason to belong to the ADA ("Strength in Numbers," November JADA). Immediately after reading this editorial, I examined a new patient, complete with study models and cephalo-metric and panoramic X-rays from a general dentist nearby.
As a licensed orthodontic specialist in Missouri, I recognize that any dentist is legally entitled to perform any aspect of dentistry in which he or she feels qualified. This is irrespective of the amount of training received in that venue, whether it is a weekend course or a full-fledged residency.
I am not arguing against that right to practice because I don’t want another "turf war" dispute. What I am incensed about is that for the ump-teenth time I’ve had a patient’s parent report that the general dentist planning orthodontic treatment spent half his time denigrating orthodontic specialists, their training and backgrounds, and their treatment plans and results. Who is teaching them these concepts and why?
Now I don’t claim to achieve great results 100 percent of the time and neither do most practitioners with whom I am acquainted. However, it really irks me that individuals who don’t have 1 percent of the training time and educational background in a specialty field that I have can make pronouncements about how orthodontists don’t have a clue about what they are doing and are furthermore doing it all wrong!
And this from someone who sends impressions and X-rays to a laboratory that provides a diagnosis and treatment plan! (Naturally, a disclaimer is included saying that the outline provided is for "informational purposes" only and that only a licensed dentist can provide an actual treatment plan.)
Invariably the treatment plan begins with some sort of "jaw expansion" appliance because the orthodontist would extract teeth. Can this be true every time? Let me ask if any of you think the lab would recommend an initial expansion appliance for every patient if it didn’t get paid for making it—that is, if the lab got the same remuneration without it?
What ties all this together for me is that, on the one hand, I have the ADA telling me why I should retain my membership; at the same time, its members are telling patients I don’t know what I’m doing.
I believe in live and let live. If you, as a general dentist, have a special interest in orthodontics and wish to learn more about it and incorporate it into your practice, fine and dandy.
However, I don’t believe you serve the best interests of your patients, the public or your profession to waste time in unsubstantiated denigration of a proud specialty. So let’s just get on with the work at hand and I hope you do it well. But give the devil his due and don’t set aside the superior training afforded to a specialist.
