One More River to Cross.

Orthodontic Treatment Can Be Applied to General Dentistry

Real Service Can be Given Patients

By Correcting Malformations

“ONE MORE RIVER TO CROSS”

By Edwin J. Blass, D.D.S.

 

                Why is it, may I ask, there are so few dentists who give any attention whatsoever to consideration of orthodontic service to children? What is the reason that these same otherwise progressive, efficient professional men allow their patients of tender years to pass through their formative period of development and give no corrective treatment when a malformation of their teeth is so apparent?

Is there a deep dark secret reserved for the comparative few specialists in this phase of dentistry? Is it possible that only children of the well-to-do and those living on or near cities can have their malformed teeth transformed to that of beauty? From my own experience, I base my contention on any belief that orthodontia is not so complex, and so fraught with extreme danger of pulp destruction and involving conditions, only possible for a specialist to cope with.

I am, I believe, possessed of average intelligence, in possession of a dental degree from Northwestern University, and studious by desire. In my years of experience as a general practitioner I have equipped and re-equipped my office several times in order to make my surroundings pleasing to the eye and a greater aid to efficiency. Post graduate courses in all phases of dentistry, attendance at conventions every year and perusal of dental publications have made me conscious of , at least, up to the minute dentistry.

If I am able, with some degree of efficiency to render professional services to those in need of mouth disorders, restoration of teeth, extraction, removal of impactions or process reductions, why should I not be able to recognize the need of orthodontic services and be able to direct the process for such treatment?

What I have done as a general practitioner in a town of six thousand people, others can do likewise. What I have accomplished orthodontically  for the otherwise beautiful boys and girls is applicable to anyone in the profession who has the will to do so.

In a previous contribution to a dental publication on this same subject, I was accorded many letters from members of the profession asking me how to make the start. May I answer inquiries from the many who might entertain the same thought relative to any initial undertaking? I will submit in reply, the procedure I followed in my first case:

Well do I recollect an anxious mother who came to my office with her young son. He was a fine strapping youngster, a joy to his fond parents in all but the ugly protruding teeth that marred an otherwise splendid nucleus of a stalwart man. Lacking even superficial training from my Alma Mater, with no knowledge based upon any previous experience, I assured the mother that I could correct the condition, possibly not wholly but at least very materially.

I constructed models of both upper and lower teeth and submitted these to a laboratory for their advice. With the appliance they constructed, crude in comparison to the present ones in use, and acting on their suggestion, I proceeded with my first orthodontic experience. In two years time, this  boy was transformed from an unsightly buck-toothed individual to one of normal appearance and a living memorial to the fact that a general practitioner can successfully practice orthodontia notwithstanding all efforts put forth to convince general practitioners to the contrary. I realize the fact that better dentures can be expected by one who concentrates this entire attention to this one branch of dentistry. Dr. Boyd Gardner exemplifies masterful technic in oral surgery. A professional ball player misses less attempts at a hot grounder and pops out more home runs than one who exercises his skill on the diamond but one day a week.

Is there any reason, therefore, for not permitting a general practitioner to construct dentures for a patient though he is not able to execute the masterful restorations of a specialist? Should you and I be discouraged and advised not to attempt oral surgery for the reason that we are not Boyd Gardners? Would it not be folly for us to legislate against the occasional ball game for the reason that a major league player accomplishes greater skill than the sand lotter?

Therefore, for the reason that Dr. “Blank” of New York City, the eminent specialist on Orthodontia accomplishes noteworthy results in correcting malformations of the oral cavity, is it deemed just and wise that I, who am but a general practitioner, should be denied the privilege of attempting to relieve a most distressing condition of one of my patients, because I am not a specialist? Are dentists not conscious of what constitutes a normal arch, and that extreme trauma or undue stress applied to single tooth invites pulp destruction, etc.? I grant the fact that a specialist should be able to render a more complete service than one who undertakes the care of a general field and yet I firmly believe, that as a physician in general practice resorts to surgery when a condition warrants the knife, so a dentist should utilize the knowledge that is expected of one who possesses the sheep skin, and practice orthodontia amongst his patients when he recognizes the necessity of such measures.

Successful CasesResult in Pride

Just a general practitioner in a hick town of six thousand people, yet I can point with pride to models of scores of cases of “before” and “after” superior and inferior dental arches. The extreme satisfaction resulting from my efforts and the gratification of parents and children of the ones concerned, has proven a greater compensation to me materially and mentally than any other dental service I could possibly perform.

I am making no attempt at self-glorification for I realize my great shortcomings. However, a diligent perusal of books on the subject and a great deal of experience in my many years of practice with arch bars and bands, have naturally improved my technic. Problems constantly arise, that cause one to feel the subject will never be mastered. Not daunted in this dilemma, I plod on and accept every case from one that responds most beautifully, with an incline plane, the desperate situation of gazing into a mouth so bereft of all semblance of normality, that to just guess what can be done, borders on mental suicide.

Restorations, Not SoleObligation of Dentistry

I wish it were possible to come in contact with every neophyte in his chosen profession of dentistry. I would stress his obligation to society, his duty to those who seek his services. I would emphasize the fact that the caring for the retention of the temporary teeth till the time of their exfoliation is not the sole nor the most important duty in child dentistry.

As important as is this phase of dentistry, nevertheless, every dentist has experienced patients with splendid permanent teeth even though his temporary ones were decayed and broken down early in life. Never have I witnessed a mal formed mouth in a child left uncorrected that did not manifest a most distressed facial deformity during the entire life of retained organs of mastification.  Bridgework and dentures have been resorted to in an attempt to correct a deed left undone, but nature’s contour of facial beauty has been wrecked beyond  repair, all because orthodontia was not resorted to.

I shall not attempt to suggest the shoulders upon whom to bear the responsibility. Is it possible that our institutions of learning are negligent in presenting the subject of orthodontia to the students as emphatically as they demand skill in gold inlay or denture technic? Whatever the cause may be, there is a solution for the problem that can be proven by every dentist in every city, town, or hamlet in the United States if he so desires it. Try this simple formula. The larger laboratories have competent men in charge of their orthodontic departments. One place that I am familiar with, employs a graduate dentist skilled in the specialty of orthodontia and is in charge of a department where appliances are constructed and advice given for correcting dental malformations.

For your first attempt, accept what appears to be a noncomplicated case, promise only your best efforts to attain the normal. Construct models of both superior and inferior arches and with a history of the case, submit them to one competent to advise you conscientiously. They will design and construct the necessary appliances. If your efforts are rewarded with some degree of success, and I have every reason to believe they will be, you will be spurred on to greater heights, and nothing but progress gained through study of books on the subject and post graduate work will satisfy your demand for a more complete prosecution of this intensely worth-while movement.

Care Must be Taken In Making Appliances

Of late, notices of places devoted to the construction orthodontic appliances presided over by graduate  competent instructors have appeared in the dental journals. Be cautious as to whom you seek advice and be not guided solely by advertisements. Proven competence must be the watchword.  Personally, I seek the services of but one concern who, even today, after many years experience in this phase of dentistry, skillfully constructs all appliances to my specifications

Dentistry means more than tooth pulling and tooth filling. Dentistry signifies that which relieves, repairs, restores, and advises and which must be accomplished by one who has prefaced its accomplishment by years of study.

Much is expected of members of our learned profession and we have the sacred duty of being the guide and counselor of those who seek our services. Let’s give a little more consideration to our dental literature and just a bit less interest to the non-essentials that confront us every day.

Orthodontia Should be a Part of General Practice

I have all respect possible for the clinicians who have extolled words of wisdom and exemplified dexterity of skill in presenting particular phases of dentistry at dental meetings. No doubt exists in my mind that their efforts in the past have contributed materially to better dentistry.

On the subject of orthodontia, I have experienced a deplorable revelation in my contact with the many dentists of my acquaintanceship. Possessed  of a keen intellect and skill worthy of bearing the title of Doctor of Dental Surgery, very few of these specialists in a branch of medicine profess any knowledge of and even confess timidness of ever attempting a corrective measure for malformed teeth.

Let’s rid our minds of this bugaboo of dental service. Grant that one feels he will not like the work or doubts his ability to attain success, yet I aver that regardless of these flimsy reasons, it is the sacred duty of each and every general practitioner to give orthodontia his immediate attention.

Picture in your mind the thousands of malformed mouths of individuals living in rural or small town localities who have no facility whatsoever nor the means of seeking a specialist’s attention. Are we mindful of our calling of our duty to the public we serve by making no attempt to heed the call of distress? Might we not demand or our dental colleges that they include a more comprehensive outline of this subject to the students they serve? We have had clinics and post graduate study on gold inlays, synthetic porcelain, dentures and exodontia to the end that American dentistry is placed upon the very pinnacle of the world’s best.

Now, may it not be the opportune time to hesitate for a moment on these subjects and inculcate in the minds of every practicing dentist the necessity of immediate consideration of orthodontia, as a necessary part of his service to mankind, the appeals of mothers and fathers for someone to come to their assistance is directed at general practitioners of dentistry.

For all that is good in our profession, for the immediate consideration so apparent and for a just compensation that is never regretted by parents, and needed today in this period of lack, determine that you will attempt immediate orthodontia attention in this field where the need is great and the workers few.

Dr. Edwin J. Blass,

Portage, Wisconsin.