In this hectic, tumultuous time, odontology is experiencing a two-fold crisis (that word which has been in vogue for several years); the economic crisis that this country is immersed in, and a professional crisis. Colleagues denounce the “commercialization” of odontology and medicine. A lack of legal regulation in many spheres of our profession. Uncontrolled, mass entry of dental chains and franchises, banks and insurance companies join to capture customers (no longer patients), open price wars; it no longer matters what you are selling as long as the patient, excuse me, the customer, signs the financing agreement and is trapped. Chains like “Dental Line” finance and then close shop, patients are left hanging (and toothless) and the professional societies say nothing. (This is the global panorama).
Within this little world of odontology we find orthodontics, one of its most complex branches; because it involves long treatments that not only require knowledge of biology, but also knowledge of physics as pertains to biomechanics and materials. However, in Spain, unlike the other EU countries and developed countries around the world, orthodontics is not legally recognized as a specialization; hence, someone with a degree in Odontology can practice Orthodontics without proper training and without an official degree that endorses his or her preparation.
Good implantologists are aghast when they see implants for €222. I am aghast daily when I see patients contacting me over Internet or coming to my office referred by a colleague to get my opinion about their orthodontic treatment. Some of them have been in treatment for years, others have just begun. Most of these patients have chosen their orthodontist because of the price or financing available for treatment, and not for the quality of the professional. Generally these patients wear poor quality brackets, poorly fitted, with remains of composite left behind, which in turn provokes inflamed gums and periodontal problems. Treatments without any plan or direction, seeking to align the teeth without any concern for occlusion or function. The solution for these patients, in the best cases, is to start over, and in the worst cases, start over and have to undergo surgery. This is “fast orthodontics”, the McDonald’s of Orthodontics — orthodontists who are not orthodontists; cheap prices to attract the patient; cheap, poor quality material — since the important thing is to start the treatment, fit the brackets, and get paid.
Ever since I began my training as an orthodontist, I have taken photos of my patients’ mouths and faces, without exception. I have always done so because I like photography; and this way I could monitor my patients’ treatments without missing any detail. It is not easy to take photos of every patient and at almost every visit– You just don’t feel like it! and it is expensive in terms of the time involved and the photography equipment that you have to have and to constantly keep updated. However, the dental photograph is our salvation! In this commercial world of iatrogenesis, the only thing that can differentiate us from these franchises, insurance companies and from professionals without an ounce of ethics, etc., is the dental photograph.
Any professional will say, to any patient, that he/she is good and can offer their patients good treatment. Even a new graduate that is a bit clever can “sell” anything and look like the best in his field. The dental photograph can be the telling factor, revealing the difference between being something or just looking like it; this difference is a matter of evidence, and the only way to demonstrate what we are able to do is through quality dental photographs.
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