A beautiful smile...
Winter ’11, #31 030411 Topic: Dental Implants: Part 4 Part 5 Part 6: PART 4: Sequential photos of implant procedure;
PART 5: Step-by-step preparation of the material required by the lab to fabricate the
crown that will be screwed on to the implant PART 6 Attaching the abutment to the implant
and gluing the crown on to the abutment
Spring, 10, #30 040310 Topic: Orthodontic Jaw Wiring presented at the meeting of the American Association of Orthodontists in
Washington, DC: [SEE POWERPOINT PRESENTATION. Documents referred to
in the PowerPoint presentation: E-Synopsis
Spring, 10, #29 03/21/10 Topic: TMJ diagnosis and treatment plan basics
Winter, 10, #28 02/22/10 Topic: Accelerated orthodontic treatment using “Piezocisons”
Winter, 09, #26 12/28/09 Topic: Obstructive Sleep Apnea: Surgical Update: a seven page PDF from the AAOMS
Summer, 09, #25 08/22/09 Topic: The article upon which is based the presentation to be given at 110th meeting of the AAO in Washington, DC
Winter, 09, #24 02/23/09 Topic: What you can do when you didn’t paid: Read the article on Small Claims Court that I wrote for the American Journal of Orthodontics in March of ’99.
Summer, 08, # 22 08/25/08 Topic: The development and application of OJW: 2 videos on YouTube
Summer, 08, # 21 09/22/08 Topic: 12 + Scenarios when you take your patient to Small Claims Court
Summer, 08, # 208/20/08 Topic: Helping your patient to diminish the fear of having four teeth removed
Autumn ’07, # 18 10 10/30/07 Topic: Article submitted to the AJO-DO October 29, 2007
Summer ’07, #16 9/3/07 Topic: How to make indirect bonding trays: detailed instructions
Summer ’07, #15 7/21/2007 Topic: Communicating with your colleagues, your referring dentists and the patients in your practice by email en masse.
Fall ’02, # 1 11/9/2002 Topics: Practice Management .. Dr. Ted: Growth and Development
Fall ’02, # 2 11/27 Topics: Preventing total data loss from your PC Dr. Ted: Preventing
the extraction of the wrong teeth.
Winter ’03, # 4 03/17/03 Topics: The Team meeting “Passions”–Part 2/4 .. Dr. Ted: Lingual braces: Indirect arch formation
Spring ’03, #5 5/3/03 Topics: The staff meeting and practice management: Part 4 of 4 .. Dr. Ted: Removing acid etch, a better method…not rocket science
Summer ’03, #6 08/30/03 Topics: Case acceptance: You won’t get them all but do you know why? .. Dr. Ted: Patient’s Financial Memo form and Notice of Informed Consent–The two most important forms in your office.
Fall ’03, # 7 12/02/03 Topics: Practice Management: Save time and money on the web. .. Dr. Ted: Clinical: Moments, Forces and Couples of Orthodontics
Winter ’04, # 8 1/9/04 Topics: Practice Management: CitiHealth Card a new third-party payment plan to encourage more patient starts. .. Dr. Ted: Diagnosis: Interpreting the Panoramic X-ray
Winter ’04, # 9 3/5/04 Topic: Practice Management: Email: Enhancing communication with patients and staff. .. Dr. Ted:Topic: A potpourri of reflections for the starting orthodontist…a series in four parts: Part I:
Spring ’04, # 10 4/27/04 Over the Wires is sanctioned by the American Association of Orthodontists
Topic: Practice Management: Automatic deductions from checking and credit cards to cut accounts receivables .. Topic:: A Potpourri of reflections for the starting orthodontist…a series in 4 parts: Part 2:
Summer ’04 # 11 7/9/04 Over the Wires is sanctioned by the American Association of Orthodontists Topic: Technology: Why Broadband is a necessity for your practice .. Topic: Dr. Ted’s approach to loss of retainers, relapse and retreatment: the Retainer Insurance Agreement
Winter ’05, # 15 2/28/05 Dr. Ted: Topic: A potpourri of reflections for the starting orthodontist…a series in four parts: Part III/IV and Topic: Table clinic on Orthodontic Jaw Wiring for compulsive overeating at the 105th AAO meeting in San Francisco. Topic: Technology: Spyware / Adware What is it? How do you protect yourself from it?
Case Study: Photos of a gingivectomy on RitaS. 113012 with her critique (Click here)
Sometimes gums overgrow the crowns of the teeth making them look too short at the end of treatment. We sculpt them to look normal
I am pleased to announce the addition of a new instrument/service in the office called the “Sapphire Diode Soft-tissue laser” and have completed the Advanced Diode online soft tissue laser training course granting an Associate Fellowship Certificate in the WCLI (World Clinical Laser Institute)* See below. This laser instrument will permit my office to offer an array of services to treat conditions that commonly arise at the start of orthodontic treatment or occur during and at the end of orthodontic treatment. One of the most common problems at the start of treatment is to expose the surfaces of teeth that are covered with gums to allow braces to be attached to them, and at the end of treatment is the need to resculpture/reshape the gums of patients whose gums have become bulbous/ overgrown/ uneven or misshapen. The Sapphire can accomplish this in most cases painlessly, without swelling and without surgery/bleeding and without the need for stitches. It has a variety of other useful applications. See Video
Below: list of YouTube videos demonstrating a variety of treatment applications using the soft-tissue diode laser for common problem seen before during and after orthodontic treatment as well as for use in treatment of some common gum diseases
The operations the 810 soft tissue diode laser can perform
The 810 Diode Soft Tissue Laser
Case Study: Photos of a gingivectomy on RitaS. 113012 with her critique
Critique: The procedure was very good. At first I was nervous I would feel the entire procedure but I didn’t feel a thing. Dr. Ted & Bryan were so catering. Dr. Ted put a numbing cream on the gum of which needed to be removed , and within 3-5 minutes my mouth starting becoming numb then he put the injection in and I didn’t feel a thing. Once my left side of my mouth was completely numb they went in and removed my gum with a laser. The procedure was calming, quick and painless. Out of a scale from 0-10 the procedure was a 0.
Thanks Dr. Ted & Bryan. RitaS.
The above settings are a good place to set your 4 preset buttons on your diode laser system. As operators learn more about the system and it’s capabilities, they can adjust the wattage up or down to fit individual preferences. Please note that these settings are suggestions only and are not a replacement for clinical judgment or training.
Brooklyn Orthodontist Ted Rothstein demonstrates laser gum reshaping Gingivectomy
This film is intended to be shown as a 28 minute film on BCAT, and as a 15-minute (or a two-part: 10-minutes each part) YouTube Video
Preparatory notes for videographer regarding filming the gum reshaping (“Gingivectomy”) procedure.
(Suggested subject of film Clip in red)
(Head shot: DrTed introduces subject)
Overgrown gums can substantially detract from an otherwise beautiful orthodontic treatment correction of a patient’s smile, and at times even impede the progress of orthodontic treatment dramatically. Consequently, one of the most common problems at the completion of orthodontic treatment is the need to resculpture/reshape the gums of patients whose gums have become bulbous/ overgrown/ uneven or misshapen. The soft tissue diode Laser can accomplish this in most cases painlessly, without swelling and without surgery/bleeding and without the need for stitches. It has a variety of other useful applications.
(shot revealing Kal-El’s overgrown- -BUT NOT INFLAMED–gums)
(Shot back to normal gums)
(Shots of the Diode Laser)
Soft Tissue Laser Gum Reshaping Using the Diode 810 Laser: Kal-El Johnson– age 15y/o
The expected time to complete the reshaping is 45-60 minutes.
Family and patient have visited the drted.com laser gum reshaping page and previewed the pertinent videos. The INFORMED CONSENT is an especially useful document for it provides important and helpful information to both the Parent-Patient and the Doctor. It should be included as part of the video. http://drted.com/LaserGumTrimmingGingivectomy.htm
(Film Clip showing the informed Consent)
Parent must read and sign the Inform Consent which is located on the same page as the videos.
Kar-El is seated where Dr. Rothstein usually treats him.
Just in back of the patent’s dental chair is placed the Diode Laser in the top of the portable suction machine (which may or may not be used- usually not).
We will briefly acquaint Kal-El with the procedure and what he will experience.
(Medium Shot of Dr. Ted and Kal-El in the chair listening to DrTed describe the procedure and asking question as may be the case. Dr. Ted will show Kal-El the finger-up method to indicate he want DrTed to stop)
All members of the team will be wearing Laser safety-glasses including the videographer, Kal-El, Brian and myself. (Shot of Sign)
The Laser Safety Officer staff member will have posted a sign outside the treatment room warning that a laser procedure is being performed and “Please do not enter” during Laser Reshaping Gum Reshaping procedure.
(Close up of gums being painted)
We will begin by paint his gums high up with a gum numbing ointment and then wait for 5 minutes.
This will numb the area where I am going to give him an injection of local anesthetic “Novacaine”. He will be given one injection to the right of his midline and one to the left of his midline.
The gum-numbing ointment greatly reduces the discomfort typically felt when an injection is given.
(Dr. Ted is shown administering the anesthetic)
We will then wait 10-15 minutes for the anesthesia to take effect on the gums that we are aiming to reshape.
During this wait we will test his gums with a semi-blunt instrument to be certain that he has achieved TOTAL /PROFOUND anesthesia.
(DrTed is shown pressing blunt instrument in to Kal-El’s gums to test that patient is profoundly anesthetized)
When anesthesia is completed and the patient assures us it is profound we can begin.
First we will photograph the gums to be reshaped the “BEFORE”
(Close-up of patient’s gums needing to be reshaped.)
We will then measure the depth and shape of the gums using a probing instrument with a small ruler and those measurements will be noted on the pre-operative sheet.
(Film showing how depth of overgrown tissue is measured with ruler-instrument, and gums marked to remove the correct amount of tissue.)
Typically Brian sits on the other side of the patient chair and assists in use of the laser reshaping since he has a perspective of the gums that reinforces our notion of the tissue that has to be reshaped (we use the term “vaporizing the tissue”
Upon marking out the tissue to be removed we set the laser machine to the watts of power we want to begin vaporizing the tissue at. Typically we choose 1.7 watts to 2.0 watts of “continuous” power. Sometimes we switch to the “pulsed” power setting and raise the wattage for more effective vaporizing.
(Shot of laser instrument control panel monitor).
Brian will “INITIATE” the tip of the laser’s electrode with carbon paper thereby effectuating a sufficient efficient energy level to effectuate the vaporizing action.
(DrTed introduce assistant Brian Millard)
(Shot of Brian “initiating” the laser vaporizing tip with carbon paper)
I will begin reshaping the gums on the patient’s right side. The power is activated and stopped by stepping on a foot-pedal.
When the laser is actively vaporizing/removing the overgrown gum tissue the laser cutting tip glows brightly and an audible beep will be heard every 3 seconds and a slight wisp haze can be noticed rising from the patient’s gums.
Where the gum tissue has been vaporized it turns color which will be visualized as being “caramel” color
(Various clips showing reshaping in action; cleaning tip of instrument and bathing surgical wound with peroxide)
We stop momentarily to take measurements to see how close we are getting to the target amount of tissue we planned on removing /reshaping.
We also stop momentarily to clean/remove the vaporizing tip of the tissue that was removed and is sticking to the tip.
We also stop momentarily to clean away tissue that has been cut but still adheres to the gums.
We frequently bathe the surgical wound with peroxide to keep it clean from tissue debris; it also disinfects and removes any tissue that shows charring.
(Various clips showing reshaping in action; cleaning tip of instrument and bathing surgical wound with peroxide)
The goal of setting the proper power level is to avoid charring and rather leave a caramel colored surgical wound.
Rarely is bleeding encountered; when bleeding is encountered it is minor and soon stops: this non-bleeding is because as the laser tip vaporizes it also cauterizes/seals the blood vessels and nerve endings.
During the procedure we constantly monitor the patient’s welfare. Indeed the patient has been previously advised to raise a finger if they want us to stop and they need to take some “timeout”
When we have completed the gums reshaping the diode laser is turned off and we can remove our glasses.
The surgical wound is thoroughly cleaned again with peroxide and covered over with a Vitamin E coating to soothe the tissue and promote healing.
(Final shot of gums reshaped to normal and back to shot of his gums at the start)
No “bandage”/covering of any kind is placed over the gums since there is no bleeding and the gums have been desensitized.
The anesthesia will wear off in 1-2 hours.
(DrTed addresses Kal-El re use of Listerine; wearing-off of anesthesia, avoidance of crunchy food and gentle use of soft toothbrush.)
Patient discomfort is generally mild when the anesthesia wears off.
Discomfort the following day, if any, is well tolerated by the patient.
We will provide 6 Advil in case discomfort exceeds patient’s tolerance which is rare in our experience.
Healing is typically uneventful over the next few days and by the 7th day the gums are back to normal.
We suggest that the patients begin brushing with a soft brush as soon as possible and to avoid foods that are crispy, crunchy and crusty so as to avoid aggravating the healing tissue.
We encourage Kal-El write about his experience with special attention to what he experienced in the days following the Laser Gum Trimming.
DrTed is shown speaking to Kal-El suggesting he write a narrative about his experience with special reference to the next seven days during which healing will take place.
Following 7-10 days of healing Kal-El returns to office.
(Shot of how gums looked BEFORE laser reshaping and how they look healed–AFTER)
(Some footage of DrTed offering a very short summary of what we have seen)
Dr. Ted Rothstein
September 28, 2012
May 21, 2006
Microimplants are temporary anchorage devices (TAD’s) that looks like a fancy albeit miniature version of a screw.
A common example of orthodontic anchorage (relatively immobile blocks of teeth) is the situation when the orthodontist wants to pull in your front teeth that are sticking out. He uses the back molar teeth to help him because they are large, multirooted, and move very little when they are used to pull back the front teeth. The molar teeth are well anchored in your jaw.
Another simple way to think of anchorage: A fisherman is sitting in a row boat and has just caught a very 150 pound fish. if he has thrown an anchor overboard, and is strapped into the boat, he can, in time, reel the fish (tooth) in toward the boat without being pulled out to sea, or being pulled out of the boat, or the boat moving from its original position. Woe to the fisherman if he failed to anchor and was close to a waterfall.
What if the patient has no back teeth? Solution…the orthodontist places two microimplants, one on each side of the jaw toward the back where the molars used to be and attaches rubber bands to the front teeth he wants to move back.
The screw is about the about half the size of the width of your thumbnail, and no wider than the width of the head of a pin. It looks like this: @— .It is generally made of Titanium steel, and is placed painlessly either with a mini-”screwdriver” or a mini-ratchet wrench following the painless creation of “starter” hole in the bone. See Tomas page 1 and Tomas page 2.
The microimplant screw is removed when orthodontic treatment is completed. It takes less than a minute to remove it, and causes no pain.
In the last 3 years much attention has been paid to this subject as witnessed by an ever increasing number of journal articles and presentations by multiple speakers who have given a host of presentations on the subject at the international meeting of the American Association of Orthodontist from during 2004, 2005 and just recently in May 2006 in Las Vegas.
Like a forest fire burning out of control orthodontists are coming to use them more and more to enable them to move teeth in ways they never could before.
It will not be long before the use of the microimplant (miniscrew, TAD) is being taught and used in every post graduate orthodontic school in the country here and abroad.
They are placed into a variety of locations in the patient’s jaw bones usually between the roots of the teeth as well as other locations nearby the roots of the teeth and on the palate.
An article in the AJO-DO vol. 130, n. 2., Aug 2006 provides the reader with the thickness of the soft tissues and cortical bone at the most common areas of placement of pins in the maxillar alveolus and the thickness of the soft tissue at the mid-sagittal suture of the palate. I am sure that soft and hard tissue depth measurements will be forthcoming from the authors in relation to the common implant sites in the mandible. [See the article.]
Their use has made infinitely easier the movement of teeth in certain cases, that heretofore was accomplished with only the greatest difficulty.
The placement of the microimplant is becoming one that more and more frequently is being done by the orthodontist. However, there are many orthodontists who prefer to have their colleague, the oral surgeon, do it for them.
The procedure takes about 20-30 minutes and is accomplished painlessly since the patient is provided with local anesthesia.
You might think that driving a screw into the bone is very painful, however, bone in fact has no nerves inside it, so once the “operator” passes the screw through the skin that covers the bone, which is about as thick as this (H) it is done without any sensation except that of some pressure.
Dentaurum is without doubt one of the leaders in this field. Their principle spokesman for their microimplant “TOMAS” (Temporary Orthodontic Micro Anchorage System) is Professor Axel Bumann. He lectured at the AAO conference in Las Vegas, 2006. (www.dentaurum.com), E-mail: email@example.com. This company has published some excellent material on this subject and you can request it as well as their DVD on the subject.
Imtec is another leader in the field: www.imtec.com (click on “Products” then see “Orthoimplant”.) You will find the Imtec catalogue on microimplants to be most instructive.
The following articles will provide the reader with a brief overview of the subject:
Thiruvenkatachari B, Pavithranand A, Rajasigamani K, Kyung HM
Department of Orthodontics, Rajah Muthiah Dental College and Hospital, Annamalai University, Tamil Nadu, India. firstname.lastname@example.org
INTRODUCTION: The purpose of this study was to compare and measure the amount of anchorage loss…
|Universal Skeletal Anchorage SystemThe Leibinger Micro Implants Universal Skeletal Anchorage System is intended to be placed in the mouth for use as an anchor in orthodontic procedures. The system encompasses three different styles of implants to give a comprehensive selection when facilitating tooth movement….|
By JOHN W. GRAHAM, DDS, MD, AND JASON B. COPE, DDS, PhD
How to manage potential complications of using temporary anchorage devices
As has been demonstrated in numerous case reports, miniscrew implant (MSI) placement is predictable and stable.1–5 However, implementation of the procedure by clinicians without adequate training in the basic biological and biomechanical fundamentals germane to miniscrews may lead to less-than-ideal treatment results or even complications. The goal of this article is to present potential complications that clinicians may encounter in the routine placement of miniscrews, and how they may be avoided and/or treated.
Inadequate Primary Stability
Primary stability refers to the movement, or the lack thereof, of a miniscrew upon initial placement. A lack of primary stability almost routinely leads to overt miniscrew mobility, with subsequent failure. Recent evidence suggests that the majority of primary miniscrew stability comes from cortical bone, with lesser stability coming from medullary bone.6…
Temporary Anchorage Periimplantitis…
Poor Miniscrew Emergence…
Undesirable Tooth Movement…
Postremoval Complications …
The Case For Microimplants
By Gaby Bahri, DDS
An orthodontist tells how he came to adopt this new technology, and how it can help your practice
Microimplants have become part of the standard of care in my practice today. I praise myself for having made the decision to include this treatment a few years back after reading an article by Kawamura.1 Since then, my team and I have offered solutions to a wider variety of orthodontic problems with more confidence and with a higher degree of certainty.
I remember the time when I left this technique for others to try on their patients and make the mistakes at their own expense; I regret every minute that I spent waiting to start on my first patient. This feeling repeats itself over and over when I hear that in Europe, like in Korea and Japan, microimplants and miniscrews are actually being used routinely by a great number of orthodontists.
Hurdles to Overcome…
Solving Day-to-Day Problems…
Common Uses of Microimplants…
ASK an honest question to yourself, how many of your cases outcome is compromised because of loss of anchorage ? How much of your energy/time/money is wasted in planning anchorage ? Half of orthodontic learning involves how to manage anchorage. No more of these Headaches, After Edward Angle the NEXT revolution is here. Call it Microimplant screw anchorage, Skeletal achorage (SAS) or Temporary Anchorage devices (TAD), name does not matter, but it sure has revolutionised orthodontic treatment.
Temporary Anchorage Devices – (TAD).
Some useful links to various manufactures websites:
Temporary Anchorage Devices
cases were shown where TADs were used to assist in the correction of antero-posterior and vertical discrepancies. In one case, TADs were used for direct inter-maxillary fixation following orthognathic surgery. However, a common concern was the stability of skeletal correction using TADs. Surgical correction is more likely to change neuromuscular imbalances, leading to a more stable correction. However this can not be proven at this time because of the lack of studies in this area. The group called for long-term stability studies using TADs. In category of correction of dental discrepancies, applications of TADs were shown for: (1) antero-posterior tooth movements, (2) molar uprighting, (3) intrusion/extrusion of single and multiple teeth. In most cases TADs were used to supplement dental anchorage, however in some applications TADs were used as the sole source of anchorage. Overall the group felt that there are many possible indications and applications for TADs and they serve as an invaluable component of the orthodontic armamentarium. In addition, it was noted that biomechanics need to be design to optimize the use of TADs.
The question re growing vs non growing patients was issued with voice of skepticism from some participants on placing TAD`s on young growing patients.
nvisalign orthodontic treatment: who is the preferred provider the specialist in orthodontics or the general dentist?
Safeguards to be aware of when choosing a general dentist as your Invisalign braces provider: Press Release
Overview of the debate: The specialist in orthodontist is far more likely to successfully correct an embarrassing smile using Invisalign than the general dentist because the specialist has the temperament to treat cases that may take as long as two years or more and has accumulated a vast knowledge and experience straightening teeth day in and day out while the general dentist has little or no experience in straightening teeth. Indeed his predominant role as a dental professional is to remove caries and place fillings, clean teeth, make crowns and bridges, remove teeth and do root canals. The general dentist is dabbling in the “art and science” of orthodontics that competent specialist take years and years of practice to hone their expertise. Moreover, specialist are far more likely to achieve a satisfactory outcome for their patients which is less likely to “relapse” compared to the result achieved by the general dentist. Finally, the specialist can always fall back to using traditional braces when his Invisalign treatment is less than spectacular, but the general dentist rarely, if ever, has such expertise. Since posting this caveat some time ago I have been consulted by five patients whose cases were mis-diagnosed and mishandled. The general dentist in each case simply lacked the know-how to bring the treatment to a successful conclusion.
Responses are invited: email@example.com
Is Invisalign dangerous for General dentists? Answered by a general dentist who no longer provides Invisalign
My general dentist wants to do my
First Read Dr. Rothstein’s perspective
June 12, 2010
A compendium of thoughts on the problems of general dentists providing Invisalign. What should the public know about choosing a general dentist to provide Invisalign treatment?
Hypothesis: General dentists, when they choose to be Invisalign providers, are more likely to make errors of omission or commission in diagnosis or treatment planning resulting in poor results to the patient’s detriment than are specialists in orthodontics.
Rationale for the Hypothesis: They do not have the years of training, experience and knowledge that a specialist has, hence, they are more likely to mistake a difficult case for an easy one. (Fools rush in where angels fear to tread). Indeed a general dentist HAS ONLY TO TAKE 7 HOURS OF “TRAINING” to become a certified Invisalgn provider. His real experience begins when he treats his first patient in his office. Would you want to be the first patient? How about being the 10th patient?
The Invisalign laboratory located in Costa Rica provides general dentists, for an additional fee, with an advisory custom-support tech who is an orthodontist to “supervise” the general dentist during the course of the patient’s treatment.
Thus they are more likely to choose Invisalign when it is not warranted, or where other orthodontic solutions are more suitable (like perhaps the option not to treat at all). Moreover, they simply do not have the training to recognize the limitations of the Invisalign treatment method.
Occasionally, the final result of Invisalign treatment does not meet the expectations of the patients, and myself, the doctor, in which case I can simply place traditional fixed braces and fine-tune the Invisalign treatment plan.
What recourse does the general dentist have? Does he typically have the experience to place bonded braces?, Hardly!. It is likely the patient will have paid good money for a bad result and will never even realize that this has happened.
Finally, there remains the problem of caring for the patient after the teeth are straightened and the know-how needed just to inform the patient what is required to prevent the result from collapsing..”relapsing”.
Orthodontic treatment is almost always a long-term treatment plan (15 -30 months) wherein the the trained orthodontist applies his knowledge to effectuate the completion of his work. On the other hand the general dentist is accustomed to completing the care for his patients in a relative short time (one day to two weeks). His training and experience as a general dentist are not conducive to the measured patience and pace at which the orthodontist carries out his work as a specialist.
When the orthodontist sees a “problem” appearing to be occurring in the treatment plan he is better prepared to understand and correct that problem that is the general dentist.
Here is an analogy that addresses the dilemma: When you board a 747 Airbus to make a transatlantic flight to Europe you know that the Captain and the crew he commands are among the most experienced and respected professionals employed by the airlines. Only then do you feel assured that if some serious in-flight problem arises your captain will have the know-how to prevent your flight from going ”catawampus”. Remember Captain Sully and the “Miracle on the Hudson?
If you knew that your pilot had limited training in the field of flying and even less knowledge about the particular plane you were boarding wouldn’t you have cause for concern? Would you even book a ticket with the airline?
In other words, if your young child has a dental problem, is it in your child’s best interest to bring him/her to the general dentist. Or, is it indeed preferable to bring them to a dentist who specialized in treating the dental problems of young children?
Moreover, if you had problem with an impacted wisdom tooth would you want a general dentist to diagnose and treat the problem? In essence, the general dentist is best suited to treat problems of general dentistry not problems that the Oral surgeon is most suitably trained and experienced to provide the most appropriate treatment. Indeed, the general dentist might completely miss certain factors that the trained specialist would note in an instant.
Orthodontics is a unique and specialized field of dentistry. Orthodontists spend 2-3 years additional full-time post-graduate study in this specialty because it is so complicated. Indeed orthodontists have to be certified to call themselves a specialist. General dentists who also ”do” orthodontics, viz. Invisalign often devote a few weekends to attend continuing education programs which touch on limited aspects of orthodontics. Consequently they are not fully trained to recognize the many nuances associated with effective treatment, or even foresee the potential problems lying in wait as they proceed. There is absolutely no comparison regarding the training and experience of orthodontists vs. general dentists. Training and experience count really do make a difference.
Having said that, a general dentist can treat the simplest of problems with Invisalign. So long as everything goes as hoped it is possible to achieve a reasonable result. However, in a more complicated treatment it is hardly reasonable to expect everything to go as one would like.
Prescribing Invisalign is just one of many treatment methods the specialist has at his disposal to address a malocclusion. There are many situations in which treatment does not go as expected. Ask yourself the question: if this happens to you, will your general dentist have the knowledge and experience to remedy the problem that arose and resolve it? Are general dentists skating on thin ice?
It’s your choice: orthodontist or general dentist? Caveat emptor!: Precautions you can take
Is it just a matter of time before we see a mounting number of legal cases involving general dentists who elected to provide the Invisalign service without having the extensive skills, training and experience which the specialist in orthodontics has already achieved?
Cc: President of the AAO, Editor-in-Chief of the AJODO, ESCO, Editor of Orthodontic Products Magazine
The most common of all orthodontic problems is “Buck Teeth” (the subject of my doctoral dissertation)