Dr Ted's new website is:
As of January 1, 2017, Dr. Rothstein has limited his practice to providing Orthodontic Jaw Wiring for Weight-Control: OJW®: Weight-control. He provides this service in Brooklyn, NY and will soon announce a new office location in Portland,OR where the Oregon Board of Dentistry on June 23 created history by ruling that Dental Professionals are at liberty to Provide Weight-control services. See www.ojwforweightcontrol.com
Contact: 718 808 2656; drted35@gmail.com


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: drted35@aol.com

Is Invisalign dangerous for General dentists? Answered by a general dentist who no longer provides Invisalign

My general dentist wants to do my Invisalign treatment which …My general dentist wants to do my Invisalign treatment which I have been told is not easy. What should I do? Our general dentist does everything including root canals… www.avvo.com/medical-advice/my-general-dentist-wants-to… 10 Dentists respond

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?

Yours truly,
Cc: President of the AAO, Editor-in-Chief of the AJODO, ESCO, Editor of Orthodontic Products Magazine

"Experience and reputation really count when it comes to providing quality patient care."