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The provision of orthodontics can be a life-changing experience for young patients whose “crooked” teeth can affect their confidence and self-esteem. Indeed, where mature patients present with a his- tory of malalignment, equally ben- eficial and fulfilling results can be achieved. In government-funded systems, patients with congenital abnormalities receive treatment that is essential to their ongoing oral health. Restorative dentists work closely with orthodontists, who can appreciate how small de- tails can aid in achieving positive restorative outcomes. As a young dentist, I corrected a tooth in crossbite with a simple T-spring appliance. It was enjoya- ble and brought a different type of delayed gradual satisfaction to the more cerebral but tenuous molar endodontics or the more artistic and instant composite build-up. I was not a specialist, but I man- aged to do some orthodontics. In contrast to my experience, gen- eral dental practitioners are now more routinely providing tooth movement with the emergence of short-term orthodontics (STO). This has resulted in some conjecture as to the methods of achieving “straighter” teeth. Indeed, some may consider STO as an emerging entity competing with specialist orthodontics, but should it be? The specialist training path- way for orthodontics involves a competitive-entry three-year full-time course linked with the achievement of a master’s level qualification that many may feel daunted by. Indeed, navigating the pathway from start to finish can be difficult academically and financially when factoring in fees and loss of earnings during train- ing. Once qualified, the majority of these specialists reside, like the majority of all specialists, in the south-east of England. With this skewed distribution of specialists and assumed need for access, it might seem prudent for general dental practitioners to contribute to meeting the need for orthodon- tics. Indeed, the long-cited man- aged clinical networks have yet to be fully realised, although all planning and documentation re- lated to managed clinical net- works identify general dental practitioners as integral to the function of the network. The num- ber of orthodontic therapists has gradually increased over the last ten years or so since inception of the first courses in Wales and Leeds. Therapists are allegedly more cost-effective to train and employ in a large orthodontic practice; however, unlike their hygiene or therapy colleagues, they cannot practise without a specialist’s treatment plan and supervision. Patients who qualify for or- thodontic treatment under the UK government-funded system need to be assessed according to the index of orthodontic treatment need. There will be an obvious shortfall of adults or adolescent patients with minor malocclu- sions who do not meet the cri- teria who would like their teeth straightened. This cohort may have to seek treatment privately from orthodontic specialists or general dental practitioners. As such, these minor or straight- forward cases may be managed in a number of different settings utilising various techniques with the advent of STO. This may have resulted in some territorial pa- ranoia between the two camps of traditional orthodontics versus STO systems. Conversely, it may be that differing scientific, techni- cal and ethical ethos on managing the same problem is the source of the debate. Quick and easy? Commercialisation has modi- fied the provision of orthodontics in the UK. Indeed, there are now orthodontic brands with courses attached and a faculty of individ- uals who promote their particular product. Companies tend to boast that their product is the best with limited complications and treat- ment being low risk, predictable and easy. Somewhat surprisingly, courses are being run on how to convert patients into orthodontic clients. There are books describ- ing strategies on promoting and increasing revenue. They outline detailed strategies on attracting more patients than one’s local competitor—or is that colleague? Sounds more like capitalism than commercialism to many inter- ested observers. The rapid development of STO has not escaped the venture (or some may say vulture) capitalists. In the same vein as DIY whitening and sports 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 middle- man(i.e.thedentist).Tomyknowl- edge, STO has yet to make it on to the price list of Samantha’s, a beauty salon in Peckham. What may cause fear and worry is that the provision of tooth movement set against a backdrop of a focus on increasing revenue and patient conversion may detract from the real reasons we are providing the treatment. The risk and benefit of treatment must remain balanced or be rebal- anced in favour of the patient. Thebestthingsinlifearerarely 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 discipline that is difficult to deliver optimally and efficiently. Treatment planning should be per- formed in person not only to ap- preciate the challenges the patient presents with but also to develop a lasting patient rapport. Equally important, patients need to be dil- igent during treatment and forever more for purposes of retention. Is it possible that a one- or two-day course with a treatment plan last- ing half a year or less can provide equally op-timal results to a spe- cialist ortho-dontist utilising tra- ditional means? In any case, placing a time limit on any treatment could be consid- ered contentious. Patients ask me all the time ‘How long is this treat- ment going to take Doc?’ I always reply ‘Ill tell you when its finished’. As such I am rarely wrong. Advertising cosmetic treatments the fair dinkum way The Australian health minis- try—recently examined the pro- vision of cosmetic procedures and in particular the modes of pro- moting the treatments. The work- ing group found that advertising and promotion more often than not focused on the benefits to the consumer, downplaying or not al- ways mentioning risks. The group went on to identify advertising practices that were not driven by medical need and where there was significant opportunity for fi- nancial gain by those promoting these. They identified the need to ORTHOTRIBUNE The World’s Orthodontic Newspaper · Asia Pacific Edition Short-term gains…long-term problems? The emergence of STO and its future implications in general practice. By Aws Alani, UK. Published in Hong Kong www.dental-tribune.asia Vol. 14, No. 7+8 © Alexis Photo/Shutterstock.com By DTI HONK KONG: The orthodontic segment has grown significantly within the past 20 years owing to new technologies and products, as well as an increase in adult patients requesting orthodontic treatment. In response to this trend and to update dentists on the most significant develop- ments in the field, Dental Tribune International (DTI) has added ortho—international magazine of orthodontics to its portfolio. The 2016 issue includes articles on clear aligners, vibration therapy and rapid maxillary expansion, as well as the latest product infor- mation and event previews. The new high-gloss English- language magazine adopts an interdisciplinary approach involv- ing orthodontics, oral surgery, periodontics and restorative den- tistry, and aims to serve as an educational tool, providing comprehensive knowledge and information on the newest tech- nology that can profitably be in- tegrated into treatment concepts. The publication, which will be dis- tributed at all major international orthodontic congresses and ex- hibitions, presents the latest re- search and case studies, as well as trends in procedures and tech- niques. Inordertoconnectwithortho- dontic specialists, the DTI team is scheduled to attend a number of orthodontic events around the globe in 2016, including the 92nd Congress of the European Ortho- dontic Society, which will take place between 11 and 16 June in Stockholm in Sweden; and the fourth Scientific Congress for Aligner Orthodontics, to be held on 18 and 19 November in Cologne in Germany. DTI will be providing comprehensive live coverage of these and other events on its website. In addition, e-newsletters about the respective events will be sent to orthodontists worldwide. From 2017, a new issue of the ortho magazine will be published twice a year with a print run of 4,000 copies. An e-paper edition of the magazine is available free of charge via the DTI online print archive. DT launches new international ortho mag ” Page 18