Criticism Quackery may not be agreeable, but it is necessary. It fulfils the same function as pain in the human body. It calls attention to an unhealthy state of things.
Winston Churchill Alex Ditmarov
I am practicing orthodontics in the country where quackery is a national standard for orthodontic treatment. Does it upset me? Not much. Especially considering that just a few decades ago the whole political system of the country was one of the greatest quackeries of the 20th century. I feel enormous gratitude for Michael Gorbachev who has stopped the communist flywheel. The total quackery fell apart into millions of tiny quackeries. Not that frightening, even amusing. One of these is called post-Soviet orthodontiya…
What post-Soviet orthodontiya is? The phenomena started its history in the early 1990s when several big orthodontic manufacturers invaded post-Soviet market. The new world of contemporary appliances was unknown, but attractive. At that time, post-Soviet orthodontists had used nothing except removable expanders and activators. The only guidelines for use of the new unknown tools were those provided by manufacturers. That is how mist and shadows overwhelmed the new specialty. Incredible self-ligation claims, promises of ultrafast treatment, extraordinary claims of growth modification became the slogans of the new specialty called post-Soviet orthodontiya. Meanwhile, fundamental orthodontic texts and scientific journals were still unavailable for the majority of self-proclaimed “orthodontic pioneers”. Language barrier, undeveloped economy and the lack of connections with international orthodontic society were among the main reasons for that. As a result, the quality of treatment was low.
Since the early 2000s, things started to change due to the development of the Internet. Post-Soviet dentists started to interconnect with their colleagues from Europe and the U.S. Accumulated knowledge and experience helped some of them to open their own orthodontic private practices. But what about post-Soviet orthodontiya as a specialty? Has it been transformed into the internationally recognized specialty of orthodontics and dentofacial orthopedics? So far, no postgraduate program in orthodontiya meets the requirements for postgraduate education by the WFO. No national orthodontic board has been created. Routine use of removable expanders is considered to be a standard and is on government financing in many post-Soviet states.
In such circumstances, it is hard to distinguish between clinicians who by their own efforts became enough competent and those who are still providing low-quality treatment because of the absence of formal training or due to any other reason. As a result, the whole phenomena of post-Soviet orthodontiya could be defined as an orthodontic quackery.
So, what could be learned from it? George Orwell’s “1984” inspired the famous Apple’s Macintosh commercial with a straightforward message – individuals provided with new technologies can stay against any, even the most frightening, quackery. I am an optimist. I believe in this idea. Quackery, is it great or small, just shows us areas that should be improved. I am sure that our modern technological society will soon find a solution to stop orthodontic quackery flywheel. During last year, I have seen several interesting tech startups and even launched my own one dedicated to the issue.
The one thing I know for sure is that the more vividly orthodontic quackery will manifest itself, the faster the solution will be found. Let us celebrate the insanity of magical myofunctional appliances, aligners-to-your-door providers, post-Soviet orthodontiya or whatsoever! It seems not agreeable at the moment, but it will benefit our specialty in the long term.