Two years ago, on this very day, my colleagues and I posted online a text entitled ‘The Young Russian Orthodontic Manifesto’. It was written to provide solutions for the improvement of orthodontic treatment in Russia, the main of which were:
- Set English language as the main language for postgraduate orthodontic programs across Russia
- Invite expirienced English-speaking academicians to teach at these programs
- Establish a Russian orthodontic board
Long story short, nothing has worked out. Looking back, I feel that these goals were too big for a country with an embryo orthodontic infrastructure. Furthermore, older generation of Russian dentists are still objecting orthodontics. They adhere to orthodontiya. What is it? In a nut shell, it is a low-quality advertising-based orthodontics regulated by former communists who speak no word of English. Orthodontiya adepts do not extract premolars, grow mandibles and regard credible research data as a Western propaganda. For more on this you can read my letter to the British Dental Journal published last summer.
Nevertheless, I still think that a board certification could and should improve the quality of orthodontic treatment both in Russia and other former Soviet states. Few months ago, I decided to bring orthodontic certification to live in a form of a digital startup and started looking for investments. While I am carrying this long and tedious venture, please enjoy the original text of the manifesto. Unfortunately, at the moment we are quite far from the goals indicated below…
THE YOUNG RUSSIAN ORTHODONTISTS MANIFESTO
The Soviet Union collapsed in 1991, exposing the sixth part of the world to a free market economy. Businesses started to grow rapidly, many from scratch, creating industries some of which were totally new to the post-Soviet world.
The first contemporary bracket systems appeared at the Russian dental market in the mid 1990s by the efforts of a group of Soviet dentists who portrayed themselves as the pioneers of Russian orthodontics. Unfortunately, these “pioneers” had very little experience with fixed appliances. Back in Soviet times, they were correcting malocclusions mostly with functional appliances which they studied from Dr Rolf Fränkel of the German Democratic Republic.
Nevertheless, in 1995 the specialty of orthodontics gained official status in Russia and became an independent discipline for postgraduate students. There was one significant mistake, however; the word “Orthodontics” was translated into Russian as “Orthodontiya” as if it were the old discipline from the times of Edward Angle.
Was this the only mistake that occurred? Not really.
Obviously, there were many additional mistakes that lead us to the crisis of the specialty that currently is evident in Russia. The orthodontic education system does not provide students with enough knowledge and experience to become independent clinicians. All the textbooks are written in Russian or translated poorly. None of professors studied abroad, and few of them speak English, even at the basic level. The only way for young orthodontists to study contemporary evidence-based protocols is to self-study outside of academia.
Another issue is the Russian Healthcare System. This system claims to provide free orthodontic care for everyone under the age of 18. In fact, the only appliance provided by the system for free is a removable Schwartz expander. The use of this appliance system alone misleads the general public about the nature of orthodontics and often creates conflicts, when parents insist on treating their children’s malocclusion only with appliances that are available for free. Can a clinician treat a malocclusion with a Schwartz expander only? Unfortunately, many Russian children are for years bombarding with Schwartz expanders, as if they are still living under a communist regime.
Without well-established standards for treatment the specialty of orthodontics in Russia loses its credibility every day, becoming a marginal discipline, hugely and often correctly criticized by both general dentists and lay-people.
Without a doubt, today we have a crisis of orthodontics in Russia.
Who we are and what do we stand for?
We are the new generation of Russian orthodontists, who were born in the times of Perestroika and brought up during the Internet era of global communications. We feel that it is our responsibility to represent the great and reputable specialty called orthodontics here in Russia. We stand for improving and harmonizing the standards of orthodontic treatment and education across Russia.
We believe that by setting higher standards of education and by creating the National Board of Orthodontics to assess these standards, we could transform semi-marginal “Orthodontiya” into the well-respected specialty of “Orthodontics”.
To eliminate any misunderstandings and inconsistencies in terms, we think it is vital to use a universal language in our specialty. The English language is now used almost exclusively as the language of orthodontic science all over the world. We think that orthodontic postgraduate programs in Russia should be taught in English, not Russian. It is necessary to invite world-renowned authorities as visiting professors to oversee training process.
To enhance the standards of orthodontic treatment throughout Russia and to encourage the spirit of self-improvement among colleagues, we are proposing to form the Russian Board of Orthodontics.
The certification examination should consist of submitting a number of well-documented cases with different types of malocclusion. The examination should prove that examinee is capable of treating cases in different extraction techniques, non-extraction cases and managing surgical cases as well.
This manifesto is the open call for the collaboration with our colleagues from the World Federation of Orthodontists, the American Board of Orthodontics and the European Board of Orthodontists. We are asking for help in forming the Russian Board, which we believe will promote the highest standards of care of our beloved specialty across the sixth part of the world.
Dr Alexander Ditmarov and colleagues
As an orthodontist, what are your thoughts on at home invisalign prototypes? Have you had patients come into an office with mishaps needing corrected?
Hi NaRae, I agree that SDC and its variations are very hazardous. However, I have never dealt with the victims of this since I practice in Moscow, Russia. Thank goodness, nothing like this is present here yet.
Hi,the type of certification you seem to be advocating for is exactly (in my view) what we go through in Canada.You might want to check out the Fellowship of the Royal College of Dental Surgeons of Canada-orthodontic certification.
I have no idea how you would practice with a preponderance of outdated ,bulky,removable appliances?Totally baffling to me !LOL
Hi Andrew, I also have quite a vague idea on why removable appliances are still pushed forward by some governments. I think to a degree this might be explained by a term “Potemkinskie villages”. Each time I raised this question publicly, I would got fired. Now I work in private practices only.
Politicians,especially those involved in healthcare control ,behave the same here ! Truth can be very elastic in their hands.
I enjoy your blog.I started in Dentistry in 75 so have seen a lot !