Perhaps I should write this editorial about the situation nowadays in orthodontics. However, I would instead like to highlight the importance of integration between this specialty and others in dentistry. In my opinion, this represents the best treatment option for our patients.
In my professional career, I have come across situations in which a static occlusion obtained by orthodontic treatment is tantamount to a good result. Unfortunately, it seems to me that orthodontists have disregarded the importance of evaluating periodontal tissue and given priority to only the type of appliance and its color. The change of arches also has been speaking louder than the biology. In the long term, this approach may achieve the desired results for the orthodontists but not for the patient. Ang brilliantly noted, “I am concerned about the long-term prognosis of teeth that experience such severe dehiscences on the labial and lingual root surfaces and question whether we should continue to close our eyes when, in the pursuit of the ideal Class I occlusion, we seem to be bringing orthodontic tooth movement beyond the biologic limits of anatomy with our mechanotherapy.”1
My main message here is for orthodontists to give more importance to diagnosing, planning, and following up cases with the specialists in the related areas. This interrelation among specialties is required to obtain long-term integral results for patients, including well-being, self-esteem, healthy buccal tissue (gums, bones, and teeth), and adequate occlusions (static and functional). This approach guarantees overall success and it results in fewer errors. McGuire wrote, “This entire conference focuses on interdisciplinary care, collaboration, and teamwork. We know that success is about developing and sustaining relationships—relationships with colleagues, staff, and patients. We should forget telling our patients about the services we provide and begin focusing on the benefits of our therapy.”2
Throughout my academic years, or better still, throughout my entire life, I was strongly influenced by a periodontist who was passionate for his profession and treated the patient as a whole. My father, a professor and clinician in periodontics, introduced me to a world that until then was unknown. This world became an intimate part of my professional and personal life, reflecting in conduct I believe benefits those around me.
As a graduate and masters professor in orthodontics at UNICID (University of São Paulo City), São Paulo, Brazil, my group and I instill in our students the importance of periodontal health during induced tooth movement. Moreover, the graduate students who participate in the Child Clinic are encouraged to apply an integration of specialties when treating patients. While new and more efficient appliances are being developed, I am optimistic that future graduates will value this interdisciplinary treatment. As future professionals, they should constantly remain academically updated and dedicated to their patients, never forgetting the importance of diagnosing, planning, and treating.
I would like to end by expressing my sincere gratitude to Deoclécio Nahás, professor of periodontics, and my source of inspiration, who passed away 10 years ago, and by quoting a wise situation:
A large company had a huge computer that occupied nearly an entire room. One morning, the employees were not able to turn on the computer. They reported this fact to the company manager, who asked them to call in a specialized technician.
The technician solved the problem by using only a screwdriver, with which he adjusted some screws. When he presented the bill to the manager, the technician was soon queried about the sum of $1,000 on the bill.
“That is absurd,” the manager said furiously. “I demand that you to give me the breakdown of the service you provided. Why did you charge $1,000 for tightening some screws?”
After some minutes, the technician handed over the breakdown in writing as requested by the manager.
Labor charges in adjusting some screws: $1
Knowing which screws to adjust: $999
Ana Carla Raphaelli Nahás-Scocate, MSc, PhD
Graduate and Postgraduate Associate Professor of Orthodontics
University of São Paulo City, São Paulo, Brazil
1. Ang G. What happened to the alveolar bone during retraction? Am J Orthod Dentofacial Orthop 2011;140:284.
2. McGuire MK. 2001 Interdisciplinary Care Conference: Five disciplines, one focus. Periodontics: The odyssey continues. Am J Orthod Dentofacial Orthop 2001;120:232–236.