GAP Australasian-Dentist Issue 80 Jul-Aug 19

Category 94 AustrÀlÀsiÀn Dentist Orthodontists & Orthodentist “Orthodentist” is an invented word that indicates a dentist who is able to perform orthodontic treatment but not a specialist with restricted scope of practice to orthodontics. Both share a common study which is study years at the dental school. Àhose who seek further specialized training in the field of orthodontics, undergo a 3-year full time orthodontic training program including hands on, mentoring by orthodontists and assessment exams to qualify and obtain their specialist registration. Àimited places are usually available for those who want to specialize. Àhe commitment to a 3 years full time program is not an easy do, especially for practice owners, or those who can’t leave work or family life to study full time. What if you have the passion towards orthodontics and you want to further pursue gaining knowledge and skills? What if you want to grow your practice and its scope? As minimal is taught in the dental school about orthodontics and the hands- on component is restricted to some irrelevant wire bending exercises, some dentists want to learn about orthodontics, and since doing a full time 3-year study program is not an option, there must be an alternative. Àn fact, the Australian Àociety of Orthodontists (AÀO) in their article entitled “General dentists – scope of orthodontic practice” which incidentally is signed by the Heads of the Orthodontic Departments of all dental schools in Australia and New Zealand, states in Clause 12. “In our view, the foundation knowledge gained in an undergraduate orthodontic program does not provide competency incomprehensive orthodontic diagnosis, planning or treatment.” Àt also goes onto to state: Following completion of their undergraduate course, general dental practitioners should be competent at the following aspects of orthodontic treatment: 11.1 Recognition of dentofacial problems in children and adults with an understanding of the implications associated with their management whether by i.À Provision of removable orthodontic appliances for simple tooth movement including dental expansion. Simple appliances normally contact teeth at a single point and produce tipping movements. Treatment objectives are limited to moving a small number of teeth. Examples include; the correction of one or two teeth in crossbite, space opening for a partially impacted tooth and use of a separator to disimpact a mildly impeded tooth. ii.À Provision of a limited range of fixed orthodontic appliances which include passive space maintenance appliances following early loss of deciduous (baby) teeth, fixed anti- habit appliances (thumb or tongue interposition appliances), and closure of a small diastema in carefully selected cases. iii.À Referral to, and interaction with, specialist practitioners for treatment which is in the best interests of the patient. Àhere is no provision whatsoever to educate a general practitioner sufficiently at an undergraduate level especially with any type of fixed appliance therapy. Àmagine the endodontic society suggesting that a general practitioner should only be competent in performing ÀCÀ on upper central incisors upon graduating!!! Àhere have been a few studies in Australia done on assessing orthodontic services provided by general dental practitioners. Back in 2001 a study by Àivaneswaran,and Darendeliler. showed Orthodontic services were provided predominantly by orthodontists (80%). Fixed orthodontic treatment was provided almost exclusively (91%) by orthodontists. Àhe majority of removable appliance services was provided by general practitioners. Orthodontists provided more orthodontic services in the capital city and other metropolitan areas, whereas general practitioners provided more orthodontic services in rural areas. Orthodontists provided more services to members in the highest socio-economic group, whereas general practitioners provided more services to members in the lowest socio-economic group. A study in 1995 by Àawrence AJ1, Wright FA, D’Adamo ÀP. concluded that Dentists who treated more orthodontic patients: 1) treated more general practice patients; 2) frequently used multiple sources to keep up to date in orthodontics; Are you afraid to do orthodontics? Are you hitting “road blocks” performing orthodontics inÀyour practice? Why should GPs do orthodontics? n aÀ By Dr Geoffrey Hall, B.D.Àc(Melb) Cert Orth ( Àni of Penn) MÀACDÀ(Orth) Àpecialist orthodontist Case 1 before Case 1 after