Truth or consequences: the potential implications of short-term cosmetic orthodontics for general dental practitioners

How long does treatment with fixed orthodontic appliances last? A systematic review

“…Therefore, patients must be aware of the objectives and limitations of each option before embarking on treatment. 8,49 If the expected treatment duration is a barrier to undertaking comprehensive treatment, on the basis of this review, it appears reasonable to suggest that comprehensive correction should not normally take much longer than 20 months.…”

“…For providers of care, there may be financial incentives in delivering more efficient treatment, most likely associated with fewer visits and shorter chairside times. 8 However, potential financial gain may be tempered by the necessity for prolonged and diligent retention associated with the placement of teeth in inherently unstable positions with limited torque expression when the objectives of treatment are confined to the alignment of anterior teeth in isolation. 5 Novel approaches, involving various degrees of financial outlay and theoretical risk, have included expensive vibratory appliances 9 and adjunctive surgical procedures to expedite tooth movement.…”

A survey of undergraduate orthodontic teaching and factors affecting pursuit of postgraduate training

“…A cornerstone of the scope of practice is the tenet that treatment be provided within a practitioner's competency 3,25 . Recent guidance on cosmetic practice issued by the Royal College of Surgeons in England emphasise the Duty of Candour when discussing the level of training that practitioners have received to underpin the provision of cosmetic treatment as well as the need to discuss both the alternatives and the possible risks 26 .…”

“…Accordingly, undergraduate orthodontic teaching is geared at developing awareness and knowledge of orthodontic aspects and the development of the dentition without equipping students with the practical skills to undertake treatment as inexperienced qualified practitioners. 2 In recent years specialist care, particularly orthodontics, is increasingly offered by nonspecialist dental providers, with short-term orthodontics (STO) gaining increasing traction among general dentists following very limited periods of training 3,4 . The merits of this development has been debated 1 and an increase in the level of litigation in relation to specialist dental procedures performed by non-specialists has been noted 5 .…”

Vocation and altruism vs business and profit

“…In the U.K., the problem of general dental practitioners being lured by fallacious treatment concepts that are based on no more than teleologic common sense has been prevalent and challenged for over a quarter of a century. [1][2][3][4][5][6] Dr Macri has suggested that the problem may be twofold: namely, that practitioners have not had the training to be scientifically discerning and that they are looking for something that was missing from their dental education, presumably more than the ability to recognize an incipient malocclusion that would require referral for specialist management, such being the cost of an everexpanding undergraduate curriculum that has perhaps marginalized orthodontics to the sidelines of predoctoral education. And into this void comes the self-proclaimed weekend orthodontic course educator who is only too willing to show how simple and easy it is, 7 not to mention the potential profits that can be made.…”