Imagine my surprise when I opened my latest issue of Dental Economics to learn that my profession had been led out of the "dark ages of orthodontics" by general dentists and pedodontists (Letters, September 1996, Dr. Duane C. Keller). At first I thought that Dr. Keller had written a brilliant tongue-in-check piece. Then I read it again the next day and realized that this guy is serious.
My first thought was, what journals do you read? While I don`t want to minimize the contributions made to the field of orthodontics by general dentists and pedodontists, it is short-sighted at best to believe that "it has been the general dentist and pedodontist who have led the orthodontic specialty into the new fields and treatments, not the specialist." That remark is insulting to the editors of every orthodontic journal, as well as the thousands of people who have published their work in those journals. Regarding the remark about re-treating orthodontic specialists` failed cases, I dare say that if Dr. Keller has been practicing orthodontics for over 20 years, that he, too, has a fair number of failed cases out there. If he claims otherwise, then he is either not treating many cases, or he chooses to only look at his cases through rose-colored glasses.
The changes toward more non-extraction treatment were not "championed by the general dentist and pedodontist," but by the sincere desire of those of us who do orthodontics (be they general dentist, pedodontist or orthodontist) to conserve as many teeth as possible in as stable an environment as possible. The problem here is that orthodontics is an art; and as such, is viewed differently by different practitioners.
I take the greatest exception to Dr. Keller`s remark that "...it is pretty clear who should be doing the majority of orthodontic therapy in the United States. The specialist should treat those cases requiring extraction...The rest of the cases should be treated by those practitioners versed in these other treatments." The absurdity of this opinion is exceeded only by my surprise at Dental Economics` willingness to publish it.
In closing, Dr. Keller and I do agree on one point-"What is best for the patient is most important." Realistically, there is excellent orthodontics being done by reputable practitioners, be they general dentist, pedodontist or orthodontist, as well as, some poor orthodontics being done by general dentists, pedodontists and orthodontists.
We should all strive to advance the profession of dentistry as much as possible by offering the best level of care possible to all of our patients. In my opinion, there is no place in our profession for such a self-righteous attitude, as the one put forth by Dr. Keller in his letter.
Dentistry divided along the lines of specialization by attitudes like Dr. Keller`s will fail for all of us. By working together as practitioners, however, we can advance our profession, for the good of our patients, intact into the next century.
Jeff G. Keeling, DDS, MS
Lubbock, TX
