Beyond blood, sweat, and systematic reviews. A bigger meaning of orthodontics?

Man’s only moral commandment is: Thou shalt think.

Ayn Rand, Atlas Shrugged

But why blood and sweat to begin with? Orthodontics is so much fun! You put all the rage appliances into patients’ mouths, make a handsome income, and everyone around adores you. Why care about anything more? You already do pretty good.

Deceptive? Yes. Let me explain.

I would like to start with an amusing situation I have been witnessing on one of the popular orthodontic Facebook groups recently. Every week or so, a young orthodontist would upload the initial records of a case asking others to guess what was his treatment plan? The following day, he would upload the final records of his treatment. The interesting part is that each and every of his cases turned to be non-extraction dentoalveolar expansion treatment with self-ligating brackets. All of them. Basically, his ostensible interest in others’ opinion was nothing but a pretext to promulgate his very dubious, one-sided treatment modality.

Certainly, the guy will be hit by a relapse train in just a few years. And certainly this situation made me discomfortable simply because I was somewhat similar to him being enchanted by the early treatment during my first year or so after the residency. I would have quite a myopic view on orthodontic diagnosis enjoying my affair with expansion. Pretty much until this had stopped being enjoyable and became troublesome. 

Of course, I wish people would learn from the mistakes of others. Especially given an overwhelming amount of evidence our specialty has collected over the years. Unfortunately, this seems against human nature to be innately prudent. We are very easily tempted by the façade of marketing propaganda which sells us pleasurable indecisiveness. You don’t want to go into the depths exploring the literature? Don’t want the blood and sweat of taking and executing challenging decisions? Just take a magic pill then! Chances are you will feel good for a while. And after all, as Lysle Johnston once ironically pointed out, “everything and anything work well enough to support a practice”. Of course, until you hit the rock bottom of the quality, integrity and self-respect…

Currently, I have been practicing orthodontics for over six years. And if I try to formulate the most meaningful lesson orthodontics taught me, it can probably be boiled down to Ayn Rand’s single commandment: thou shalt think.  Orthodontics taught me that we are the choices we make. It taught me that some choices are right and some are bluntly wrong. It taught me that seeds fallen into a shallow ground won’t bring forth anything meaningful. It taught me that we can build something long-term and stable only having a thorough fundament. It taught me that temptation is easy and restriction is necessary.

I am thankful I have a profession which encourages me to think, grow and contemplate the culture we are living in. I love orthodontics. It is astonishingly beautiful. On top of that, some recent studies tell that it improves the quality of life of our patients – this also has a meaning, doesn’t it?


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