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faculty of individuals who promote their particular product. Companies tendtoboastthattheirproductisthe best with limited complications and treatment being low risk, predictable and easy. Somewhat surprisingly, courses are being run on how to con- vertpatientsintoorthodonticclients. There are books describing strategies on promoting and increasing rev- enue.Theyoutlinedetailedstrategies on attracting more patients than one’slocalcompetitor—oristhatcol- league? Sounds more like capitalism than commercialism to many inter- estedobservers. The rapid development of STO has not escaped the venture (or some may say vulture) capitalists. In the sameveinasDIYwhiteningandsports guards, one can now have one’s teeth straightened via online companies using products delivered by Her Majesty’s Royal Mail and so cut out the middleman (i.e. the dentist). To my knowledge, STO has yet to make it on to the price list of Samantha’s, abeautysaloninPeckham. What may cause fear and worry is thattheprovisionoftoothmovement set against a backdrop of a focus on increasing revenue and patient con- versionmaydetractfromtherealrea- sons we are providing the treatment. The risk and benefit of treatment must remain balanced or be rebal- ancedinfavourofthepatient. The best things in life are rarely quick, easy and without reflection. While learning or training, one gains stature from one’s mistakes and learns by way of osmosis from those of individuals one hopes to emulate. Becoming an expert in many a field requires time, effort and experience. Orthodontics is a complicated disci- pline that is difficult to deliver opti- mallyandefficiently.Treatmentplan- ning should be performed in person not only to appreciate the challenges the patient presents with but also to develop a lasting patient rapport. Equallyimportant,patientsneedtobe diligentduringtreatmentandforever more for purposes of retention. Is it possiblethataone-ortwo-daycourse with a treatment plan lasting half a year or less can provide equally op- timal results to a specialist ortho- dontist utilising traditional means? In any case, placing a time limit on any treatment could be considered contentious. Patients ask me all the time‘Howlongisthistreatmentgoing to take Doc?’I always reply‘Ill tell you whenitsfinished’.AssuchIamrarely wrong. Advertising cosmetic treatments the fair dinkum way The Australian health ministry recently examined the provision of cosmetic procedures and in particu- larthemodesofpromotingthetreat- ments. The working group found that advertising and promotion more often than not focused on the benefitstotheconsumer,downplay- ing or not always mentioning risks. Thegroupwentontoidentifyadver- tising practices that were not driven bymedicalneedandwheretherewas significantopportunityforfinancial gainbythosepromotingthese.They identified the need to regulate pro- motion and advertising ethically with factual, easily understood in- formation from a source that is independent of practitioners and promoters.Thisisunfortunatelynot always readily available. In some Australian jurisdictions, there are specificguidelinesthatneedtobead- hered to for promotion of cosmetic treatments and they specifically cover before and after treatment ad- verts, which we know in the UK is a popularpracticeamongthecosmet- ically driven. This is commonly one ideal, perfect case showcased on the frontendofthepracticewebsitewith no mention of any problems, either acute or chronic. Another aspect of the report detailed prohibition of time-limited offers or inducing po- tential customers through free con- sultations for the purposes of treat- mentuptake.Thelatterissomething that has seen STO promoted by way of voucher deals on the Internet or viasmartphoneapplications.Others may consider such a practice as loss leading; one could ask who is losing andwhoisgainingandatwhatprice? Oneimportantaspectofthereport identified the wider social impact of cosmetic procedures in that people maybecomeincreasinglydissatisfied with themselves and their appear- ance,culminatingindeeperconcerns forthepersonandreducingscopefor individuality.Manydentiststhrough- out the country may have a slipped contact here, a rotation there or a space distal to a canine who are un- likely to be waiting in earnest for the next voucher deal alert on their iPhones. Inducing misgivings or rais- ingconcernsaboutthepatient’stooth position where the teeth are other- wisehealthyandthepatientpresents withnoconcernscouldbeconsidered unethical and worryingly dishon- ourable. Relapse of confidence In a recent publication from an in- demnity provider, orthodontics was identified as an emerging area for claims against their clients. This is likelytobethetipoftheiceberg,whose sizewillprobablycontinuallygrowas more and more orthodontics is pro- videdandtherepercussionsofwhich mayonlybecomeapparentgradually inthefuture. Inthenowhighlylitigiousarenaof UKdentistry,thefailureoforthodon- tic treatment against the backdrop of Montgomery v. Lanarkshire Health Boardislikelytoresultinincreasedlit- igation. The movement of teeth into whatthepatientandthedentistfeelis the correct position may be possible intheshortterm,butinthelongterm complications may arise owing to a varietyofsoft-andhard-tissuefactors that cannot accommodate this new and supposedly “right” position. In- deed, orthodontics requires the ap- preciation of detail where symmetry and alignment are “king”, but long- term stability is the likely “empress”. Relapseofpositionisacommoncom- plaint and where patients have paid handsomely for a result they may have been happy with at the time of the cheque clearing, over time tiny toothshufflescanresultindispropor- tionateandvehementdissatisfaction. Where teeth are moved indiscrimi- nately,recessioninthelabialsegment is a complication difficult to explain and remedy in the high lip line of a conscientious and ambitious cor- porate female patient. Indeed, more haste, less speed may result in a case being etched longer in the memory of the patient and the clinician for thewrongreasons. Clear steps to business building A cornerstone of a successful busi- ness is the repeat customer who val- ues the dentist and his or her service and returns with no qualms or mis- givings about what the dentist feels should be provided. A successful bu- siness relies on patients returning in the long term owing to their positive experiences. Focusing on short-term gains without due consideration of quality or reliability of the treatment providedhaspotentialrepercussions forpatients,thebusinessofdentistry andperceptionoftheprofession. 05Dental Tribune United Kingdom Edition | 5/2015 OPINION Aws Alani is a ConsultantinRe- storative Dentis- try at Kings Col- lege Hospital in London, UK, and aleadclinicianfor themanagement ofcongenitalab- normalities. He canbecontactedatawsalani@hotmail.com. Y education everywhere and anytime Y live and interactive webinars Y more than 500 archived courses Y a focused discussion forum Y free membership Y no travel costs Y no time away from the practice Y interaction with colleagues and experts across the globe Y a growing database of scientific articles and case reports Y ADA CERP-recognized credit administration ADA CERP is a service of the American Dental Association to assist dental professionals in identifying quality providersof continuing dental education. ADA CERP does not approve or endorse individual courses or instructors, nor does it imply acceptance of credit hours by boards of dentistry. www.DTStudyClub.com Register for FREE! AD DTUK0515_04-05_Alani 15.10.15 12:02 Seite 2 DTUK0515_04-05_Alani 15.10.1512:02 Seite 2