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

Some will argue that orthodontic manufacturers pursue their interests all around the world and this is just how things work. However, we have to bear in mind that before XXI century orthodontics was barely known in Eastern Europe, while the current heads of postgraduate programmes here are often former communists with very peculiar moral and ethical values. As a result, there is no help from academia to young orthodontists appealing for a common sense. By now, we are almost armless against the brutal force of flashy advertisement that enslaves students by flawed knowledge on a daily basis… our orthodontic boat is penetrating deeper and deeper into the heart of darkness.

But who is more of a savage here: Russian Ivan who is gluing brackets without getting cephalometric records or a westerner John who is bombarding poorly educated audience with the ridiculous claims of the magic powers of some brand-new self-ligating appliances? I don’t have an answer. I only know that greed and disrespect to others have greatly contributed to the fact that in the former Soviet Union we have zero number of certified orthodontists as well as no postgraduate programme that meets the requirements from the WFO.

It is clear to me that the establishment of a good study programme should be a first-step solution. Of course, this is hardly possible without the help from manufacturers. But they should act in a responsible way and should not try to present their products as superior denying scientific evidence. They also should be very careful with whom they deal with, since often people portraying themselves as ‘professors’ here have no real knowledge of orthodontics.  

I think that orthodontic manufacturers will be the first to benefit from treating young local orthodontists as equals. This would create good business environment for a long-term partnership. However, if the things will not change there is a chance that local public may one day rebel and ban the whole orthodontic industry in their land… Why do they really need it, if it brings nothing good apart from severe protrusion, cortical bone loss and phony slogans of pro-expansionists?

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