and redone. A child with crowded incisors can have much more stable alignment of those incisors when treat-ment is begun before the teeth have completely erupted and connective tissues formed to hold them in rotated and unattractive positions. Can you imagine, less relapse? Can you imagine a child not being teased, “Why do you have so many teeth? They are ugly!” Most any child with adverse growth – growth that is off the normal -can benefit immensely from treatment to direct and redirect growth toward the normal. And, many children and their parents can rejoice in “Phase I and done”-orthodontic treatment in the mixed dentition, when the permanent incisors and molars have erupted. The bite can be corrected, the tooth align-ment can be made beautiful, and the space can be created in the upper and lower jaws to allow the remaining teeth to erupt without problems. Phase I and done can happen with a knowledgeable pediatric orthodontist, in about 70-80% of children. (There are children who will need a second phase of treatment because of their severely ectopic – out-of-place-erupt-ing teeth, or because of adversities like tongue position, severe trauma, extra teeth or missing teeth.) And for those children, the Phase I treatment will reduce the length and complexity of Phase II treatment, will reduce the need for permanent teeth extractions and will improve the view the child has of himself-and the view others have of the child. The Phase I treat-ment will reduce the need and risk of need for surgeries later. The Phase I treatment provides more stability, and less need for compensation-moving teeth around to hide the FLK face. The Phase I treatment will reduce the need for the child to adapt to less-than-ideal growth, less-than-ideal bites, and less-than-ideal esthetics. When we are considering terms and the changing meanings of terms, let us consider that “Early” treatment is not a great term, as it may imply, “too early.” Traditional orthodontics at age 11-13 is “Late” treatment, truly. Yet, let us not label it as negative, either. Let us expand our views of orthodontic and orthopedic treatment to celebrate Interception Orthodontics (iOrtho™) which transforms smiles and lives as early as possible. Interception 30 Spring 2014 JAOS Orthodontics is available and prudent as early as it is possible, and feasible. Let us give our child patients a beauti-ful self-view, give their parents the most beautiful children, make it easier for the patient and parent because the younger a child, the better the compli-ance. Let us reduce the need for perma-nent teeth extractions and surgeries, provide more stability, have growth follow our treatment as guide, and help our patients need less compensa-tion less adaptation. And, let us create healthy occlusions for lifetimes. Bottom line-treat as early as it is possible-and feasible-to redirect and “The Gp’s Gp’s have have been been our our “The knights in in shining shining armor. armor. knights The Gp’s Gp’s have have looked looked The for – – and and found found – – the the for educational opportunities opportunities educational they need, need, and and brought brought the the they resulting competencies competencies resulting to their their patients.” patients.” to harness growth, to provide child patients a beautiful self-view, provide their parents the most beautiful chil-dren, make it easier for the patient and parent through the compliance of the young child, to reduce the need for permanent teeth extractions, for surgeries, and for compensation treatments, to provide more stability and the healthiest occlusions possible for lifetimes. Orthodontics is one of the areas of dentistry in which formal residency programs offer the dentist the luxurious opportunity to spend time focused singularly on the area of moving teeth into better positions. And, like the other specialty areas, pediatric dentistry, endodontics, periodontics, oral surgery, orthodontics is one area in the purvue of the generalists, the Gp and the pedi-atric dentist. The American Orthodontic Society has dedicated itself, its instruc-tors, and its resources, to providing the same kind of education for the general-ist that can be obtained in a specialty residency in orthodontics, and with the ongoing continuing educational oppor-tunities to continue to grow and develop mastery in the area. Pediatric Dentistry residencies are fascinating stand-outs in the specialty areas of dentistry because the pediatric dentist is a generalist, a gate-keeper. The Pediatric Dentist provides compre-hensive care to the child patient, just as the General Practitioner does to his patients. The generalist is licensed to and should provide care in any and all areas of his education and his compe-tence, including preventive and restorative care as well as endodontic, periodontic, surgical, and orthodontic care. Yet the Pediatric Dentist is often reluctant to provide “other-“specialty care, after his experience in his own “specialty” residency. Somehow the dentist who completes the Pediatric Dental residency often comes to believe that they should provide, and should be comfortable in providing preventive and restorative care, the hallmarks of their residency training, and refer other specialty care. We have seen the Gp dentist who finds himself in a community where his patients need specialty care, often without adequate specialists available, is the lead in educating himself in such specialty care. The Gp’s have been our knights in shining armor. The Gp’s have looked for – and found – the educational opportunities they need, and brought the resulting competen-cies to their patients. The Pediatric specialty community has amazing resources for the child patients, their parents, and the Gp’s, and I am proud of my specialty as its members broaden their interest and involvement in the area of orthodontic and craniofacial orthopedic treatment, bringing in their extraordinary work-ing knowledge of growth and develop-ment, child patient management and their successes in transforming lives of these patients. From the time I graduated from dental school at the University of Kentucky, I was fascinated by the possi-bilities of orthodontics for the dental patient. And, following my residency in Pediatrics at U of Connecticut, I was offered a year – long fellowship in the orthodontic department there, by Dr. Sam Weinstein. While at UConn, I learned from Dr. Charlies Burstone, Dr. Lou Norton, Dr. Ravi Nanda. I was fascinated-and fortunate. Dr. Leonard Carapezza was an invited speaker on several occasions, and shared his passion for orthodontics in the practice of pediatric dentistry. Dr. Walter Doyle was the world’s first dual specialist in Pediatric
Journal of the American Orthodontic Society Spring 2014: Page 30
