EDITORIAL

The American perspective:

Orthodontics – The first specialty of dentistry is at be? Moreover, are they the chosen ones to pay for the
risk to be the first to disappear attitude (if not the sins) of the rest?
Unless steps are taken to prevent it, we will lose
Despite the good economic times and impressive ad- our specialty. Imagine a scenario in a dental school
vances made over the past twenty years in our field, far away, where time has come for all the orthodontic
we may not have orthodontics as a specialty much faculty to retire or to resign. There are no full-time
longer. There are several reasons for this, but the orthodontists to lecture, conduct the preclinical labo-
most imminent one is the potential for the disappear- ratory sessions, assign patients, grade exam papers,
ance of the orthodontic department. report the final grades, etc. at the predoctoral level.
Why would an orthodontic department disappear? In order to stay accredited, the dental school curricu-
This question has a simple answer: There cannot be a
lum must contain orthodontic courses. How will the
department without faculty. The current lack of full-
administrators handle this problem? Certainly it will
time faculty is the most significant crisis we had to
be no sweat off their back to ask the pedodontic
face since the inception of our specialty. Much of the
department to teach orthodontics. As bizarre as it
current full-time orthodontic faculty have gray hair,
may sound, this is a trivial event compared to the
and some no hair. Once this fifty- or sixty-something
bigger issue. The bigger issue is that this dental
crowd retires they will not be replaced. There are
school will no longer have a graduate program in
only a handful of full-time faculty who have the inter-
orthodontics either. As this trend spreads to other
est, enthusiasm, and skills necessary for a career in
schools around the nation, the graduate orthodontic
academics. Unfortunately, many of this already small
program, as we know it, will disappear.
group will give up the academic life to put bread on
The specialty status is granted by the American
the table and pay their children’s school tuition.
Dental Association. To be a specialty, the field must
Whether senior or junior, the income of a typical
be special, have an organization, a board certification
orthodontic faculty member is many fold less than
what a practicing orthodontist can earn. All the stud- process, a journal, and an educational system. In the
ies conducted to understand the core of full-time absence of any one of these elements, the field is not
faculty dissatisfaction come up with the same conclu- special to be recognized as a specialty. If orthodontics
sion: the full-time faculty salary is not an incentive to can be taught by pedodontists or other specialists,
do the work. The other and intangible element is that how can anyone claim it to be special? The orthodon-
the full-time faculty is not really ‘accepted’. They may tist will no longer be a specialist.
even be the subject of ridicule when the young doc- Imagine the orthodontist is not a specialist!
tors (to borrow a phrase from LE Johnston, Jr.) get A small group of wise men realized this could hap-
together for a quick beer. pen and founded the AAO Foundation. The purpose
Clearly, this is disgraceful. The full-time faculty of AAOF is to support the orthodontic education. The
have accepted that they will indeed get paid a little support is in many forms, but mostly the foundation
less, and they will put up with the politics of their funds the orthodontic research that would not be
institution. Not to mention they will put in endless funded by other means, and the young faculty with
hours of work – but why? It is because they under- salary support. The money to do all this comes from
stood the importance of education, advancing the the interest accrued. But who cares if the ortho-
field, and giving back. Above all, however, to ensure dontist is recognized as a specialist? Only less than
the sustenance of the specialty. They have chosen to 23% of the membership. Sadly, a good number of
make sacrifices for the greater good, the future of those sponsors are the current residents. Many of the
orthodontics. They believe looking after their fellow practitioners who contribute do so at the minimum
persons is important. But how big must that sacrifice level.

Clin Orthod Res 4, 2001/1–22 1

For example, the regent level sponsorship requires bies would have no impact. Could those free treat-
a pledge of $25000. It can be paid over a 10-year ments not be given to the department or to the
period. Simple arithmetic reveals that this is a $208- specialty and, most importantly, to the AAOF in re-
a-month contribution. Where else do we spend $208 turn for self-respect?
a month? An orthodontist who goes out to eat, say, There can be no excuses for not supporting one’s
three times a week will leave more than $208 in tips practice, principles, and pride. The issue is the sur-
for the waiter. If the orthodontic community’s self-re- vival of our species. Not to contribute $208 a month
spect in being a specialist is less than the tip left for is a vote for extinction. Often we hear ‘someone
the waiter, then not much could be said. Obviously, ought to do something’. Who might that someone be?
the orthodontist is neither special nor he/she de- If read carefully, the O of the AAO spells orthodon-
serves to be a specialist. Perhaps, the non-contribut- tists. It is the organization of the orthodontist, not
ing 76% of our members fall into this category. orthodontics. The orthodontist is that someone who
Chances are they have not given to their departments ought to be doing the something. Dear colleagues,
either. Yet, they preach to others the importance of time has come for all orthodontists to put their
tithe. money where their mouth is. Being a specialist, in
It is hard to imagine there exists an orthodontic particular an orthodontist, is worth more than the tip
practice that does not give away free treatment. For a left on the restaurant table. Don’t give away your
dentist’s kid, a family member, a friend, etc. At the specialty. Don’t let it be the first to disappear.
end of the fiscal year, when the income and overhead
figures are assessed, how can anyone tell that they Orhan C. Tuncay
gave a treatment or two away? Clearly, the few free- Editor-in-Chief

2 2Clin Orthod Res 4, 2001/1–2