GAP Australasian-Dentist Issue 80 Jul-Aug 19

Category AustrÀlÀsiÀn Dentist 95 3) perceived their patient base to contain more children; and 4) were likely to have attended a Àruitt course. Àhe provision of orthodontic services was associated with a higher level of continuing orthodontic education as well as treating more general practice patients, especially children. And these studies are 18 to 24 years old – even before Ànvisalign reaching our shores – and we all now know the impact that aligner therapy has had in both general and specialist practice – not to mention the array of other orthodontic courses available. Based on discussions with orthodontic and aligner suppliers -at least 50% of orthodontic cases today are performed by general dental practitioners. Àhe question is “Can and should dentists provide orthodontic treatment”? Àhe answer is yes, but there are conditions to this answer. Àince orthodontic treatment is usually a long-term commitment with a patient and each case has its unique features even if some might seem to share common problems, orthodontic knowledge, and problem-solving ability requires special training and mentoring until one is totally competent. Àowadays, orthodontic treatment is not limited to fixed appliance comprehen- sive treatment, however, the clear aligner orthodontic treatment, or short orthodon- tic pre restorative orthodontic treatment is becoming more common every day. Àew techniques and the use of technology in orthodontic treatment has helped the general dental practitioner to be able to introduce orthodontic care to the practice. Clear aligner treatment, indirect digital setups are among those. Àreating patients with clear aligners requires the dentist to have knowledge about orthodontics which can be obtained through a day or few days course. However, these courses neither provides the comprehensiveknowledge of orthodontics. Don’t be fooled and believe that aligner therapy is easy and the case tracks as per the digital treatment planning – many orthodontists call this “cartoondontics: you need to understand and master a lot of knowledge including but not limited to – aligner biomechanics which is different to fixed braces biomechanics, understanding attachments and force delivery, velocity of tooth movements, overcorrections required for many cases. Otherwise your cases will V finish as per the digital setup – and you and your patient will be frustrated and disappointed. Ào be able to perform orthodontic treatment, the dentist needs to enrol in a comprehensive orthodontic course, that offers a thorough curriculum, mentoring, and regular updates. Àhis is the key to success if a general dentist wants to provide orthodontic treatment at a high level with predictable and profitable results and have happy patients. Why orthodontic speciality is different than other fields of dentistry? Às it the uniqueness of each case? Àhe long term commitment with patients? Àhe fact that it has not been taught sufficiently well in the undergraduate dental training. Or the paradigm that it is a such a difficult branch of dentistry that should only be limited to OÀ HODO ? Will a general dentist who is trained to do orthodontic treatment, be independent and will not refer cases to the specialist? Àhe answer to that question is absolutely not. Àhere will be cases that the general dentist with sound orthodontic knowledge will not feel comfortable to treat and know it’s beyond their comfort zone and skill level. Hence, the dentist will refer to the orthodontist. For that purpose, there should be always a good mutually respectful relationship between both parties to cooperate and interact not for who will treat the patient, but for the greater purpose of what is the best for the patient. Àt should be similar as in other branches of dentistry like implants, wisdom teeth extractions, Àndodontics, Prosthodontics, Periodontics and Paediatric dentistry. Àhe dentist may have skill in all of the above fields, but still there will always be a need for referral to the specialist due to their level of expertise and knowledge, because that’s what they do all day, every day. Àhere should be good communication between other specialities and the general dentist, mutual patients, and even for a referral for a second opinion. Why is it different in orthodontics? Àf one can find a comprehensive orthodontic course, that is taught by an orthodontist with great knowledge and a great teacher and one that includes hands on training and mentoring, ensure the course will address the gamut of orthodontics in addition to continuous learning and mentorship, that would be the ideal path for general dentists who wish to practice orthodontics and incorporate it in the practice. Àhere will be time, effort, money invested, and a long-term commitment if the GP wants to learn orthodontics properly. Ào why should the GP not pursue the passion towards the area of Orthodontics? Doing the short orthodontic courses like those for clear aligners, or short fixed appliances courses, can be the first step – but it should only be the first step to proper orthodontic education. Àf you want to succeed to be good, ÀO, be better, be the best! Do not devaluate, decrease or diminish the others. Give your patient the best treatment, time after time. Care for your patient. Àhis is the best way to build a good practice. And finally, if you don’t believe you can do it – see the cases below that were done by general dentists À trained. Yes anyone with quality training can do it – but choose your training wisely – a course that will make you think ,make you understand all the principles and push your boundaries – not a course which just gives you a “cookie cutter or cook book approach “ – Cookie cutters and cook books DO ÀOÀ WOÀK in our profession. u n aÀ Case 2 before Case 3 before Case 2 after Case 3 after