EDITORIAL Is It Almost Done?
ince I graduated from dental school, quite some time ago, orthodontic procedures have improved greatly. The way patients and doctors look at any orthodontic treatment is very different. We are in an era where time has never been so precious. People do not have enough time in their life to do all the things they want to do. That is probably why many orthodontic clinicians advertise that they have a technique to treat faster. We all see the future of orthodontics being oriented towards faster and better treatment. A few questions come into my mind on this futuristic film of faster and better (don’t you think it sounds like a movie title). One of these questions is: “Are we really faster?” And, a second question,“Why do we want to be that fast?” It is probably easier to answer the second question than the first. Why? Patients demand a shorter treatment time. Doctors, have you had braces in your mouth as an adult? Not to mention teenagers who, the vast majority of the time, want the treatment to be finished by about the third month. As for me, I did have braces as an adult and, let me tell you, that time is of the outmost importance. For the patient, shorter treatment time is better. For young active adults with a career that may force them to be very mobile or for multidisciplinary cases that need orthodontic preparation, keeping the treatment time to a minimum has never been so important. And, since periodontal tissues dislike long treatment shorter is better. For the orthodontic clinician, the shorter treatment average promotes referrals and will increase productivity, being able to treat more patients in the same amount of chair time. Other motivating factors may be the influence of the advertisements and publications of the manufacturers with their marketing strategies to make us question ourselves if we do not get into that fast track approach. Some are motivated to treat faster when observing their competition and thinking that if they do not reduce their treatment time they are not in the game to the point where they may think that they are out of date or doing something wrong. For other clinicians, there may be many more reasons why they want to treat faster. The second question is: “Are we treating faster?” The answer is yes, without a doubt. With the progress of science and technology such as better understanding of growth and development, better memory wires and better manufacturing procedures, the control we can have has improved. Also, since the percentage of extraction cases is lower, we have less space to close with the consequence of reducing the duration of treatment. IJO
Michel Champagne DMD, MAGD, IBO, CDE Editor We still have some gray areas and one is “are we more knowledgeable in growth and development and can we control treatment relapse?” Answering such questions may be difficult. Recently I heard a prominent chair of an orthodontic department making this opinion comment: “Many new graduates today are less knowledgeable and more mechanically oriented because they want to move teeth fast to be productive. When they come out of school, they want to be able to pay back their debts and benefit from a high standard of living as soon as possible.” We must ask ourselves if productivity should be our prime objective. We may get charmed by the manufacturers of different appliances like brackets and wires or stimulation assisting appliances and techniques that are supposed to boost treatment efficiency like Acceledent, Propel, Piezocision and others. I have nothing against improving my treatment outcomes, I am personally charmed and intrigued by all those new things but every time I have the temptation of using any new product or technique I go through a very strict review of the independent literature to decide myself that the change is worthwhile. I will not take position on any of them but I urge you to look at the literature and make your own decision in the seriousness of the literature and on the clinical effectiveness of any new product. After all this, I conclude that we take less time to treat for all of the above reasons. However, faster does not always equal better. Patient’s health, wellness, function and also attractiveness should be placed above all. Our biggest challenge today is to encourage patients to collaborate to the treatment that he or she NEEDS and not to the treatment that he or she WANTS knowing that we cannot all always have it our way.