cosmetic dentistry - beauty & science

I 31 opinion _ un-cosmetic dentistry I cosmeticdentistry 3_2012 which these dentists (Drs Swain, Barr or De Paul) appear to teach very well. I would rather remain on the fringe of even these trend-setters, and offer my twisted perspective with less corporate influence. AshugelypopularastheseSTOcoursesare,there ishoweversomepotentialforabusebydentistswho simplyhaveaweekendcourseandnoothertraining in orthodontics. While I would rather see a dentist do more orthodontics than veneering, orthodon- tists are partially justified for their concerns about GP orthodontics. Taking courses alongside orthodontists and reading their journals, it is apparent that there is negative sentiment directed towards general prac- titioners who dare to bracket teeth. I do feel that a united profession is a favourable concept but, having experienced extreme levels of sabotage in mylocalarea,Inowreferlessthaninthepast.Some othergeneraldentistshavementionedsimilarprob- lems (on online forums) with turf protection that appears oddly focused on orthodontics. Anarticlerecentlyusedtheterm“softscience”to describe orthodontics, and I would certainly agree that it is difficult to claim that orthodontists know the “right way to straighten teeth”, since few of them agree on anything. The reality is that the schools of thought in orthodontics are as polarised as the holy war between the myo-centric doctors and the centric relation believers. As an example, the use of the Herbst appliance forces the TMJ forward, in an attempt to correct a deficient mandible. This is like someone standing on the balls of her feet to be taller. While the prac- tice appears to be commonplace, there are ortho- dontists who would never use this technique on their own children or grandchildren. The studies always seem to conclude with a recommendation forlong-termdata,butthedevicehasbeenusedfor 100 years already. Mandibles are not stimulated to grow after all, and patients may be holding their jaw forward in a Sunday bite simply to get their uncomfortable braces off. Orthognathic surgery may be vastly under- utilised in some cases and overused in others. The use of TADs appears to offer some promise, and while an oral surgeon may find it a nuisance to bother with placing them, a general dentist may be able to get them in place with little difficulty. Orthodontistsoftentrembleatthethoughtofusing aneedle(likeIdidindentalschool),sothepricegoes up as the patient heads to the oral surgeon. BIAS:Aparticulartendencyorinclination,espe- ciallyonethatpreventsunprejudicedconsideration ofaquestion;prejudice So this article is obviously biased towards ex- pandedskillsforthegeneraldentist,butIdorespect the need to pick your battles in treatment and refer when the case demands it. I essentially do not be- lieveinputtingupwithanyrubbishfromspecialists who want to dictate what a general dentist can andcannotdo.Ifyoudonotlikemyideas,toughluck because the ones you have may not stand up under close scrutiny. I do not want to waste my time jus- tifying anything I choose to do and if I am taking a coursebesideanorthodontistwhoissnivellingthat he will start doing fillings and extractions, that is awesome; I may have an opening for an associate. As excited as I am about STO, I think a two-day course is only a taste of what you need to know. It is liketakingatwo-dayselfdefenceclassandthenthink- ing you can enter mixed martial arts. The problem is not what you learn, but the cases that you attempt Anterior alignment is completed in extremely short periods of time, as in this example the lateral incisor was proclined in only 3 1/2 months. (DTI/Photos M. Zuk, Canada) “I know, NOTALLcosmetic dentists are Veneer Nazis, ...”