General practitioners and orthodontics

Abstract

W e practice in stressful times. In many communities, in the courts, and in the editorial and letters columns of many dental journals, the antagonism between orthodontists and general practitioners who perform comprehensive orthodontic treatment is intense. W. H. Howard, in a 1984 editorial in General Dentistry. ’ has suggested that orthodontists have been more resistant than any other dental specialty group in providing general practitioners with continuing education and other information regarding their specialty, and more aggressive in advertising and in seeking restrictive clauses in third-party programs. I have no doubt that these generalizations are true. General practitioners interested in providing orthodontic treatment tend to see these behaviors ,311 the part of orthodontists as defensive, damaging to the dental profession, and either bordering on or being outright unethical and illegal. Most orthodontists see these actions as necessary, appropriate, and impeccably ethical. Clearly, what we have here, at the very least, is a major failure in communication. Individual general practitioners have been more active and effective than orthodontists in making the basis for their position known. Although the orthodontic specialty, primarily through the activities of the American Association of Orthodontists, has taken a number of actions that seem to have as an underlying rationale the position that general dentists should not perform comprehensive orthodontic treatment, we have been hesitant to state this fact bluntly and to defend it. The purpose of this essay is to provide one perspective on why, indeed, general practitioners should not be undertaking full treal:ment orthodontics. The 1979 guidelines for predoctoral dental education in orthodontics” state that “the general dentist should be able to recognize and treat uncomplicated localized orthodontic problems . . . . The usual tooth movement should be accomplished by simple tipping movements of selected teeth.” This is further qualified by the specific statement that “the student will not de-