Changing public perceptions about Orthodontic Treatment
Over the last 21 years in practice I have seen the public perception (and
newer dentists’ perceptions) of braces/orthodontics move from seeking advice
from the Orthodontist to making decisions based on here-say, google searches,
neighbor stories and even from well-intentioned (but less educated) general
dentists. In the past it was common
place for dentists to refer all kids at age 6 to 8 to their local orthodontist
for evaluation. Dentists knew their
limitations and their education and realized that the specialist (Orthodontist
in this case) was the only one educated enough to make a decision on treatment
for advanced early cases of growth dysplasias, etc.; they also realized that
the orthodontist was going to be obligated to tell parents if something was
missed years earlier and now removal of teeth or even surgery would be
necessary to correct a malocclusion.
Children’s dentists would never attempt orthodontics because as a
specialist themselves, they respected the more focused education we as Orthodontists
had far above general dentists and pedodontists alike (same that makes them
better suited to treat children’s teeth with regards to maintenance and restorative
work) when it came to correction of malocclusions.
“Dentists knew their limitations
and their education and realized that the specialist (Orthodontist in this
case) was the only one educated enough to make a decision on treatment”
Fast Forward now to 2017 and we have information overload,
competition for patients not only between different generations of Orthodontists
but also between general dentists and children’s dentists, and we have
companies marketing directly to the public with so-called “alternatives” to
braces and wild claims of success that has been disproven both with experience
and research. It is really no surprise
that the public is lost in a fog of dis-information and poor advice. So who should the public trust? Clearly there is only one of these groups
that is specifically trained for years and has many more years of experience
with straightening teeth and correcting jaw dysplasias through early growth,
answer is: TRUST THE PRIVATE PRACTICE ORTHODONTIST!
“It is really no surprise that
the public is lost in a fog of dis-information and poor advice”
What I have seen (and what I have also discussed with practitioners
across the country) is that many dentists and children’s dentists are not
referring patients until they perceive a problem. This may be fine for the patient with obvious
problems that show up right at the time they may require correction (and the
patient goes to the dentist right at the right time) but I am here to tell you,
the public, that dentists and children’s dentists do not have the education or
experience to identify and diagnose skeletal dysplasias, identify borderline
extraction cases or realize when the facial esthetics may be compromised by
poorly developing dentitions. These means
you can expect higher risks of removing permanent teeth, higher risks of
impacted teeth requiring surgery, higher percentages of cases with
non-treatable skeletal dysplasias and less stable future corrections.
“… I am here to tell you, the public,
that dentists and children’s dentists do not have the education or experience
to identify and diagnose skeletal dysplasias, identify borderline extraction
cases or realize when the facial esthetics may be compromised by poorly developing
dentitions.”
So why aren’t dentists referring patients to be screened?
Well some dentists have busy practices and they leave screening up to their
hygienists (who have even less knowledge).
Other dentists may have a pre-conceived notion of braces as a treatment
only for crowded teeth and they may be waiting for all permanent teeth (which
is very detrimental to most patients and drastically reduces options for
treatment if/when the teeth do eventually erupt); many times I have seen
patients coming in at age 13 or 14 with impacted teeth that could have been
prevented or with huge overjets/overbites that now require surgery to correct. There are other dentists that simply feel they
know better and actively dissuade their patients from orthodontics and instead only
to offer their own brand of alignment with less accurate clear aligners as if
they are the same as braces (which they most certainly are not). No matter the reason, the fact is always the
same: The Orthodontist is the only professional that is specifically trained to
identify and to treat developing malocclusions and skeletal dysplaisas (hence
the specialty of Orthodontics &
Dentofacial Orthopedics).
In short, there is no logic in waiting for a dentist to tell
you there may be a problem with your bite or your children’s developing
dentition when they simply do not have the knowledge or experience to identify
all problems early. This is no dig on my
brothers and sisters in general dentistry; I don’t ever judge their root canals
or restorative work and would consider it malpractice if I even attempted some
of the things these general dentists can do for my patients. But when it comes to orthodontics, I want to
have every opportunity to provide the best treatment possible for my patients
without being handicapped by actions/non-actions due to less knowledgeable or
even down-right bad advice.
Contrary to advertising efforts by Invisalign and propaganda
from less educated (and sometimes outright biased) sources, Orthodontics is not simply a specialty of
Esthetics; Orthodontists are not esthetiticians to be placed on a level with a
nail salon or spa. Orthodontics and
Dentofacial Orthopedics is a dental specialty requiring years of specialized
training and education beyond college and dental school. We are there for
you and your family, for your health and long-term function as well as to
provide beautiful but lasting smiles. We
will always work with your dentist and other doctors but we are the ones that
must decide how to treat and when to treat you and your family if you want us
to provide you with the best, most stable, most efficient (and usually the most
affordable) options.
If you have questions or comments concerning this or any
orthodontic question, please feel free to make a complimentary new-patient
appointment at either my Steiner Ranch location or my North-central Austin
location on West 35th street and MoPac.
Dr. James R. Waters is
a 1996 graduate from UTHSC Dental School in San Antonio, 1997 graduate of
Advanced Dentistry from the UNMC in Nebraska and the 2001 Valedictorian
graduate from the prestigious Saint Louis University Orthodontic Program
receiving the J.P. Marshall award for clinical excellence in 2001. He holds a Bachelor’s Degree in Science,
Doctorate in Dental Surgery, a post-doctorate certificate in Advanced
Dentistry, post-doctorate Degree in Orthodontics & Dentofacial Orthopedics
and a Master of Science Degree in Orthodontics and is a Diplomate of the
American Board of Orthodontics. Dr.
Waters and his wife of 20 years live in Austin, TX with their 4 children where
he has a thriving, multi-faceted Specialist practice with locations in Steiner
Ranch and North-Central Austin. You can
learn more about Dr. Waters at BracesAustin.com.
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