Integrating Orthodontics into General Practice
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Ben Miraglia, DDS
There has never been a better time for a general practitioner (GP) to add orthodontic services to his or her practice. The process begins with continuing education. Today’s educational programs cover a variety of topics that range from clear aligners and traditional braces to interceptive orthodontic techniques for children, including myofunctional appliances. Most orthodontic programs for GPs also offer educational opportunities for supporting team members in the dental practice. This opportunity to expand a general practice’s services by integrating orthodontics can be rewarding on multiple levels, but how should practitioners approach the process?
The single best way to introduce orthodontics into a general practice is to begin offering clear aligner therapy. The current leader in clear aligner orthodontics is Invisalign®. In the Invisalign Fundamentals course, a doctor learns how to use clear aligners to competently treat teen and adult patients who have mild amounts of spacing or crowding of the class I variety. Typically, these are orthodontic relapse cases. It is a realistic goal for a GP to be able to confidently care for patients with class I malocclusions exhibiting mild to moderate levels of spacing or crowding. Given the incidence of malocclusion and the rate of relapse from traditional orthodontic procedures, this can translate into a significant amount of patients for the practice.
In total, Invisalign has developed approximately 200 hours of continuing education, including live events and online training. Furthermore, Invisalign has a network of territory representatives who are available to support doctors and team members in their efforts to provide a quality orthodontic service to their patients.
Once a GP has successfully incorporated clear aligner therapy, some consideration should be given to learning more traditional orthodontic techniques. This path opens up the opportunity to provide orthodontic treatment to the younger patients in the practice.
There are several orthodontic educational programs designed specifically to teach traditional bracket and wire techniques to GPs. The United States Dental Institute has created one of the most comprehensive programs available, and its courses are offered regionally throughout the country. Courses are available for a wide variety of topics, including diagnosis, treatment planning and delivery, and case finishing and retention. The institute also offers 2-phase non-extraction interceptive orthodontic training, which enables GPs to offer expanders and functional appliances to treat children between the ages of 7 and 11. The early phase establishes the correct foundation, while the second phase focuses on final tooth alignment. Providing the early phase is an excellent way for a GP to grow his or her future Invisalign teenage patient population.
The next level of orthodontic education that GPs should consider involves the prescription of removable myofunctional appliances for children and teens. During the last 27 years, the Myofunctional Research Company has developed orthodontic appliances (eg, Myobrace®) to improve the dental and facial development of children who are 3 to 15 years of age. The Myobrace system not only straightens teeth, but also treats the causes of crowded teeth and incorrect jaw development. To help GPs with adoption, the Myofunctional Research Company offers CE and training for the whole dental team.
While incorporating myofunctional appliances, there is a natural progression toward learning orofacial myology. The Academy of Orofacial Myofunctional Therapy offers continuing education related to orofacial myofunctional disorders. These are disorders of the muscles and functions of the face and mouth, which can directly and/or indirectly affect breastfeeding, facial skeletal growth and development, chewing, swallowing, speech, occlusion, temporomandibular joint movement, oral hygiene, stability of orthodontic treatment, facial esthetics, and more. Most orofacial myofunctional disorders originate from insufficient habitual nasal breathing or from mouth breathing.
The final frontier in orthodontic education for GPs concerns airway and facial development in the treatment of breathing problems, such as sleep-disordered breathing. The Raphael Center for Integrative Education focuses on orthodontic techniques and philosophies that address both the prevention and treatment of airway-related, orthodontic sequelae. Courses cover a wide range of ages, from infancy to adulthood, and conditions, including pain and sleep disorders. Team training is an important part of the curriculum because, in a wellness-based practice, the team plays an important role in patient health education. In addition, these programs emphasize an interdisciplinary model of patient care.
The American Academy of Physiological Medicine and Dentistry provides opportunities for interdisciplinary collaboration and education regarding optimal airway growth, development, and function. The organization is an inclusive group, and it offers a variety of continuing education courses for all members of the dental team that are designed to improve the overall health and well-being of patients.
This educational pathway affords the GP an opportunity to comfortably, effectively, and profitably integrate orthodontics into his or her practice. It begins with moving teeth and ends with improving a patient’s quality of life. By embracing the principles of lifelong learning and pursuing continuing education, today’s GPs can deliver quality orthodontic services to their patients that contribute to their overall health and happiness.
Ben Miraglia, DDS, maintains a private practice in Mount Kisco, New York, that focuses on comprehensive family care dentistry.