The Heart of Darkness

I always had a special feeling to Joseph Conrad. Apparently, some Polish genes or the fact that I spent my very first years by the sea or English that has also become for me more useful than a first tongue… I don’t know. But I can’t stop feeling that the landscape around is not getting any brighter.

In this post I decided to write on a rather unappealing topic: orthodontic colonialism. I came up with this term recently, however I am certain that I have been experiencing its effects for the last seven years. This all started at my residency in Moscow. The quality of education was low. Most of the things we were taught were bluntly wrong. We were told jaws can be grown, extractions are unnecessary and comprehensive early treatment is what you should definitely do to every child who enters your office. Furthermore, the only brackets we were obliged to use were self-ligating brackets from a famous American manufacturer.  

After residency, I started travelling to explore orthodontic landscapes in different parts of the world. To my surprise many eastern European colleagues were telling me that they have had similar experience during their postgraduate studies: several big brands would make deals with the heads of orthodontic programmes that would subsequently result in an uncontrolled flow of biased information to orthodontic students. I can’t help feeling that this to a degree resembles the deals western colonizers would make with the heads of indigenous tribes buying lands and slaves in exchange for glass beads and other trinkets.

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The Conciliation, 1840 by Benjamin Duterrau

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The most meaningful things in orthodontics I am aware of

I have recently returned from Italy where I have been taking a course in orthodontic mechanics specific to treating adult patients. It was held in the city of La Spezia by a famous Italian orthodontist, Giovanni Biondi, who, among many other titles, is a secretary general of the Italian Association of Specialists in Orthodontics and an ambassador of Italy in the American Association of Orthodontists. I have learnt several useful tips and tricks and am sure this will help me a great deal since during this year I am experiencing a surge in the number of adult patients.

I also had a chance to visit Florence where I clearly have been through a condition called Stendhal syndrome. Our host in the city was an Italian psychoanalyst and a specialist in Carl Jung. The apartment was packed with books and journals on the subject. Most of them were in Italian, so I did not have a chance to expand my knowledge in psychoanalysis. However, even my superficial acquittance with Jung and perhaps the atmosphere of this beautiful psychoanalytic studio turned apartment made me come back home in a “Jungian” mood. It is known that the pivotal topic of the Swiss psychoanalyst was the quest for meaning in a life of an individual. So, for this blog post I decided to dig for the most meaningful things in orthodontics I am aware of. Surprisingly, it was an easy task…

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Moses Beholds All the Work, 1966 by Marc Chagall, a world-famous Russian-French artist

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Should we treat others as we want to be treated?

Last week, I watched an interview which brought me some tough time thinking. It was Neal Kravitz interview on Facebook. He is a famous American board-certified orthodontist based in South Riding and Ashburn, Virginia. He has published dozens of articles in all the major orthodontic journals. These texts are always explicit and helpful. He is also very active on Facebook (Orthodontic Pearls group) sharing useful pieces of clinical knowledge. Once I even translated one of his texts into Russian for Kevin O’Brien’s orthodontic blog.

In the interview, Neal discussed several issues regarding practice management, the importance of good documentation, relationships between colleagues, etc. Everything in his positive though pragmatic style. I like this attitude. He spoke a lot on the importance of being tolerant to imperfect referral cases from our peers and the need to protect each other in the eyes of our patients.

If we look closely, the overall message of this one-hour interview can be simplified to a pivotal philosophical concept of the entire western civilisation: treat others like you want to be treated. And this is where my tough time started…

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On reading

A friend of mine, a Moscow-based maxillofacial surgeon, once had a playful sticker on the bonnet of his laptop, it went: ‘Reading is sexy’. No doubt, reading is an excitement, a pleasure and often provides long-awaitied answers for troublesome questions. However, as with any pleasurable activities reading requires some protective measures…

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André Kertesz, from ‘On Reading’ series

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Smile Delight

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– So, if we do not have more proposals for today, we are happy to announce the end of our board meeting…

– Lieutenant O’Neal-00, I have one more for your consideration.

– OK, sergeant G-84, very briefly, please…

– Uploading the data…

– Oh, c’mon! Have you undergone the recent software update, sergeant?

– Yes, sir! Loading… 5 seconds, 3 seconds… Here we go…

Project name: Smile Delight

Project type: Self-destructive hypnosis

Pathophysiological mechanism: Digestion inhibition

Initial agent: Chewing disturbing device

– Sergeant! We do not harm them evidently! This is the violation of the rule number one! I am sorry to tell you, but…

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On language

Language is the best orthodontic tool. The language. The specialized English language that has been cultivated on the pages of orthodontic literature during the last one hundred years.

Two years ago, I started my blog with a question ‘Can we study orthodontics in a foreign language?’ I came to a negative conclusion then. I didn’t change my mind today. However, I want to share some thoughts on language again. Particularly on my mother tongue…

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A sculpture “Forward” by Erik Bulatov, a prominent Russian/Soviet non-conformist artist. Photo: courtesy to a/political and the artist

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The end of orthodontics, or is it?

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A month ago, Kevin O’Brien published in his popular orthodontic blog a post titled ‘Are these the early days of the self-destruction of orthodontics?’ The text was inspired by his visit to the annual AAO meeting where he has been giving a lecture on Bill Proffit’s legacy.

The situation around orthodontics was presented in a desperate tonality: key opinion leaders maliciously misguide young specialists, the American market is plagued with teledentisty, Europe is full of myofunctional charlatans, etc. As a result, we are awaiting the end of the specialty.

After reading the post, I felt a bit disappointed. Firstly, I have just started practicing orthodontics less than 5 years ago and do not admire the perspective of its nearing death. Secondly, despite the fact that I admit the presence of all the issues listed, I don’t think they are fatal. Paradoxically, they might be even beneficial.

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Two-year anniversary of the Young Russian Orthodontists Manifesto: Where we are not going…

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Two years ago, on this very day, my colleagues and I posted online a text entitled ‘The Young Russian Orthodontic Manifesto’. It was written to provide solutions for the improvement of orthodontic treatment in Russia, the main of which were:

  1. Set English language as the main language for postgraduate orthodontic programs across Russia
  2. Invite expirienced English-speaking academicians to teach at these programs
  3. Establish a Russian orthodontic board

Long story short, nothing has worked out. Looking back, I feel that these goals were too big for a country with an embryo orthodontic infrastructure. Furthermore, older generation of Russian dentists are still objecting orthodontics. They adhere to orthodontiya. What is it? In a nut shell, it is a low-quality advertising-based orthodontics regulated by former communists who speak no word of English. Orthodontiya adepts do not extract premolars, grow mandibles and regard credible research data as a Western propaganda. For more on this you can read my letter to the British Dental Journal published last summer.

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A dog’s bite

Last month I visited an art exhibition entitled ‘Not Everyone Will Be Taken Into the Future’ by a Russian artist, Ilya Kabakov. He emigrated from the Soviet Union in 1988, the year I was born. In the West he became known as the most expensive Russian living artist, after one of his paintings sold at auction in 2008 for $5.8 million. The exhibition is his rare appearance in Moscow, the city where he studied, worked and lived most of his life.

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An exodus project

Exodus story constantly repeats in world history with different players in different circumstances. Unable to accept ideology, low moral values or just straightforward unprofessionalism, people unite into groups to stand against unbearable states of affairs.

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Freedom, 2015 by Erik Bulatov, a prominent Soviet non-conformist artist

Exodus is not always a physical migration. It also can be done by establishing strong rules inside a new group. The American Board of Orthodontists established in 1929 by Albert H. Ketcham is the example of an ‘internal’ exodus. Nowadays board certification seems the only method to stay against a growing industry of pseudo-medicine. In my opinion, today it is time to make board certification available for every orthodontist around the globe.

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