The key factors for future orthodontic prosperity: A commentary paper

Fabio Ciuffolo.



In this brief commentary paper, we elaborate the differences between people-centered orthodontics and appliance-centered orthodontics with the clinical and extra clinical key factors that may help orthodontists in achieving prosperity in the future.


In the past two decades, remarkable changes have occurred in the orthodontic field, from master-oriented orthodontics to key opinion leader (KOL)-oriented orthodontics, with the current perception that evidence-based orthodontics is secondary to commercially driven orthodontics.
Until then, excellent masters in orthodontics were recognized worldwide as excellent clinicians and taught teaching orthodontics with the aim of spreading the art of diagnosis, treatment planning, and tooth movement.
Instead nowadays, self- or company-nominated KOLs tutor the use of a particular appliance and explain its superiority over others. Consequently, orthodontists are now considered merely, appliance (d)ea(l)ers, rather than (l)ea(d)ers of intellectual performance in diagnostic and therapeutic approaches.
This change has fostered the development of appliance-centered orthodontics (ACO), which targets patients’ problems instead of orthodontists’, when the orthodontists should be the ones to apply the actual evidence available at the moment and their clinical skills in a specific patient with a specific malocclusion.
Therefore, dealer companies have started believing that ACO is the key for communicating the orthodontic message to lay people so that they would seek the treatment dealers of a specific technique or appliance.
This kind of ACO leads to several concerns that are summarizes following: First, this approach is strategically mistaken[1] because people do not want to associate with tools that will engage them, cost them, and even make them “suffer” in some way;[1] second, the communication conveyed by the companies directly to the “consumers,” who are patients, could stimulate the demand for “do it yourself” (DIY) orthodontics, a growing phenomenon,[2] because the specialists are by-passed, with possible consequent injuries for the public health; third, these companies try to increase their own profits as they have to respond to their investors, and hence, may send a budgetoriented message, that is, ethically and morally questionable, rather than to send a desirable code-oriented message. Indeed, people-centered orthodontics (PCO) should be the ultimate goal for accurate communication of the orthodontic message, because people should be aware of the need and benefits of orthodontic treatment,[1] and the role of the orthodontist in achieving these objectives, as orthodontics should not be a self-medication discipline or appliancecentered therapy. Interestingly, orthodontics may contribute to the improvement in public health,[3] especially in the postpandemic era, by improving patients’ quality of life.[3] The orthodontists as well as their staff should aspire for not only simple profit but also prosperity, because orthodontics provides growth, development, better life prospects, and confidence in the future, for all people involved in PCO. Therefore, the aims of this commentary paper are to share the key factors that may be helpful in achieving prosperity using PCO, to help the orthodontic community overcome the crisis faced in the past 20 years, including the current coronavirus disease-2019 pandemic, and to contribute to the necessary health and socioeconomic reconstruction.

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