by Marc Bernard Ackerman, DMD, MBA

We are definitely smart enough to revive our moribund specialty.  As a matter of fact, we do some pretty incredible work!  Every day I am blown away by some of the novel techniques and treatment results that colleagues post in online discussion groups.  On many occasions I think to myself, you’re not working hard enough to stay at the vanguard of the specialty.  Yet, am I or for that matter are any of you who actively participate in online groups, that far from the forefront of the specialty?  I think not.  I believe that our loosely organized digital community is so far ahead in thought that we shouldn’t self-flagellate over such trivial contentions as the quality of photographic documentation in practice or the best reference plane for cephalometric superimposition.  However, the one-sided argument is pervasive in orthodontics and is precisely why we find ourselves in a perpetual rut.

Orthodontics can no longer survive as a black and white misconception.  It’s all about Kodachrome!

The problem comes down to some fundamental flaws in how orthodontics is taught, who is actually doing the teaching and what group is controlling the whole business of education.  I would like to suggest who the 800 pound dragon in orthodontics is and present a plan to tame or slay it.

Here are the facts:

• An orthodontic residency program must have a single program director who is full-time for a program to be accredited by CODA
• Orthodontic residency program directors must be certified by the American Board of Orthodontics for a program to be accredited by CODA
• The program director and faculty must prepare students/residents to pursue certification by the American Board of Orthodontics per CODA accreditation standards
• The program director must document the number of graduates who become certified by the American Board of Orthodontics per CODA accreditation standards
• Treatment outcome in orthodontic residency is often measured by the American Board of Orthodontics objective grading system (OGS)
• Patients treated in orthodontic residency programs are exposed to the entire battery of diagnostic records required for American Board of Orthodontics certification whether or not they are of clinical import or necessity
• 30% of practicing orthodontists are certified by the American Board of Orthodontists

If you said that the 800 pound dragon in the specialty is the American Board of Orthodontics, I would have to agree with you. So what can we do?

My plan is as follows:

• The orthodontic majority must demand that the ABO make changes that will represent all orthodontists (the Jorgensen Proposal)
• If the ABO does not wish to come to the table and really make the necessary changes, the orthodontic majority will have to create a new specialty board and petition the American Dental Association and Commission on Dental Accreditation to recognize the new body
• The orthodontic majority must fight to repeal the CODA standard of a full-time program director (this is not financially viable nor desirable for the best and brightest clinicians best suited for program direction)
• The orthodontic majority must fight to suspend the requirement of board certification of the program director until changes in the board certification process have been ratified
• The orthodontic residency curricula must be in parity with how orthodontics is practiced today both technically and operationally (conventional edgewise in 2017?)

I think this would give us the opportunity to cast orthodontics in the proper light with the consumer and will eradicate division amongst our ranks.  It’s time for the silent majority to exercise their vocal chords!