Seminars in Orthodontics
VOL 22, NO 3
Orthodontics/pediatric dentistry:
issues of common concern
Introduction
hen Elliott Moskowitz offered the oppor-
W tunity to guest edit an edition of Seminars in
Orthodontics on Orthodontics and Pediatric Den-
tistry, a thought immediately came to mind: do we
really need another conversation about early
treatment? Fortunately, for all of us he was not at all
interested in that idea. He was challenging me to
put together something much more substantive.
From that evolved the working title for this edition:
Pediatric Orthodontics: Beyond E.T. (Early Treatment).
So, I sought out old friends like Joe Ghafari, Tim
Wright, Nina Anderson, Rob Peracchia, and Olivier
Nicolay, and some newer friends such as Sarah Ahn,
Courtney Chinn, Paul Chu, Anthony Macari, and
Ramzi Haddad, as well as a number of former and
current students like Nadia Laniado, Eva Maestre,
Matt Miller, and Shira Bernstein, and Stephanie
Colaiacovo, to get the job done. What came out of
this interaction is now here for your consideration.
Socio-political concerns
Access to care
We hear these words all the time but what do they
really mean and what does it have to do with the
future of our practices? Quite possibly more than
one may realize. It certainly can make all the
difference for the children and adolescents that
need our services. Nadia Laniado’s article on the
matter is an enlightening dissertation on the
matter—in many ways, ironically, a “Tale of Two
Specialties.”
Medically necessary
Another term often discussed but rarely appre-
ciated. Most of us readily understand the
& 2016 Elsevier Inc. All rights reserved.
http://dx.doi.org/10.1053/j.sodo.2016.05.001
Seminars in Orthodontics, Vol 22, No 3, 2016: pp 159–160
SEPTEMBER 2016
relevance of this concept for pediatric dental
care, but what about orthodontics? Our patients
perceive the need for our care but do we as
specialists in the field concur with their per-
spective? And more importantly where is its place
in healthcare? Joe Ghafari’s insightful discussion
on this topic challenges our parochial perspec-
tives about our specialty’s place in the healthcare
delivery continuum.
Communication
Although it is at the core of everything that we say
and do, when there is a lack of it, usually bad
things happen, e.g., misunderstanding, non-
compliance, dismal outcomes, and can even lead
to litigation. Proper use of communication usually
leads to positive outcomes and shows your patient
that you really care about them and re-enforces
their trust in you as their care provider. Eva
Maestre and her husband Rob Perrachia present a
compelling story on how they have integrated the
magic of communication, and its corollary, edu-
cation, into every aspect of their practices.
Oral healthcare concerns
Non-cavitated and white spot lesions
Both are challenges for all of us to be involved in
and mandates that our specialties work better
together on each of them. The former, often
called “Hidden Caries,” ironically, may have
evolved from our successful use of fluorides over
these many decades, the latter, curiously, too
often the negative side effect of creating an
esthetic dentition.
Dental trauma
Always an important area of common concern
and interest for both specialties and Courtney
Chinn has done a masterful job using a single
159
160 Cisneros
case to illustrate an ideal collaborative approach
to the management of this situation.
Transdisciplinary concerns
Hereditary dental defects
Tim Wright’s article on the subject is a “state-of-
the-art” comprehensive exposition that remark-
ably simplifies a very complex dilemma. It is an
encyclopedic discussion of some of the more
challenging anomalous conditions that we will
see in our practices. It also provides us access to
online databases to better define the clinical
conditions that challenge us. One can easily
envision this article become part of the reading
lists for both the ABO and the ABPD.
Airway and facial growth
This has been a topic for controversy in growth
and development that has existed dating back to
and even before E.H Angle, himself. The coher-
ence of Anthony Macari’s and Ramzi Haddad’s
treatise on the issue transcends all of the historic
hullabaloo and beautifully discusses the topic in all
of its depth and breadth—another potential and
appropriate candidate for the Boards’ reading lists.
Eating disorders
Lastly, Nina Anderson and Olivier Nicolay
present a timely conversation about a condition
that needs much more attention from the dental
community at large. It is a long overdue discussion
on this topic for us in dentistry in an area that we
all can contribute to help recognize and treat
individuals suffering from such disorders.
Conclusion
As you can see, we have attempted to touch
upon a number of common areas for concern
for us as healthcare providers. Yet there are so
many more candidates for discussion and col-
laboration, i.e., childhood obesity, self-percep-
tion, speech language disorders, and, of course,
early treatment and cleft lip/palate/craniofacial
disorders, as well. The list could be quite
extensive.
Orthodontics and pediatric dentistry are two
of the finest specialties in healthcare—the for-
mer, the oldest in dentistry, the latter the fastest
growing specialty. However, what make us so
special are the patients that we serve. The child
and adolescent, are among the most vulnerable
as they are the least able to protect themselves
and have the lowest access to healthcare. Let us
continue to advocate for them, keep our energies
focused to work in partnership to enhance
healthcare outcomes for them all.
George J. Cisneros
Guest Editor
E–mail: pedort@aol.com