Sir, - Further to the correspondence regarding the orthodontic waiting lists, it is worth noting that irrespective of the figures quoted, it is an undoubted fact that throughout Ireland there are thousands of children suffering from maiming and disfiguring malocclusions who are missing out on corrective treatment and who will never be treated.
This need not be the case. Many of these cases could be treated by General Dental Practitioners (GDS) who have acquired the knowledge either at a post-graduate level or better still with a more enlightened and practical approach to undergraduate education.
Orthodontists provide a valuable service but their workload is huge and their time very expensive. However, major improvements in many malocclusions can be made by GDPs, particularly the most common disfiguring one of the patient with the undershot jaw and consequently "buck teeth". This can be effectively and quickly treated using simple removable upper and lower appliances which work in tandem and are called twin blocks. In function they are in effect orthopaedic appliances because not only do they align the teeth but also the jaws, by translating the lower jaw forward and thus also restoring a nice facial profile.
The same result for this disfigurement and other malocclusions can be even more easily achieved if tackled when development is still at an even more fluid state between six to nine years using soft plastic appliances known collectively as ortho trainers. Used extensively in countries such as Japan, Australia, the US and Holland, they need very little extra expertise by the dentist to supervise their use. When one considers the disfigurement that the simple habit of unchecked thumb sucking can wreak, one can appreciate how rubbery the mouth is at a certain age, and how easily changes can be made by these devices.
Ordinary dentists, with the help of these user-friendly appliances and with a little extra acquired knowledge and expertise can bring much needed orthodontic care to a far wider public, particularly within the confines and financial constraints of the Community Dental Service. This would free orthodontists with their specialist knowledge to concentrate on the heavy load of specialist demands and needs of our population including of course any necessary finishing and "perfecting" of treatment undertaken by the GDPs. - Yours, etc.,
Liam O Droma,
Community Dentist, Howth Summit, Co Dublin.