Wednesday, March 1, 2017

Public Perception of Orthodontics


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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