Journal of Orthodontics

The period since the war has seen a vast increase in the amount of orthodontic treatment provided for children in the United Kingdom. This is currently given by practitioners within the general dental service, orthodontists in the former local authority dental service and by consultants and their teams in the hospitals. The training programme for consultants has been evolved but there is a need for appropriate training programmes for other orthodontists. While we have reason to be proud of the present situation, there is room for improvement.

This paper is intended to highlight some of the acute problems facing educators who are responsible for devising orthodontic curricula. A rational approach to future planning of educational objectives requires a realistic evaluation of the future professional role of today's students.

A case is presented for a two year basic specialty training in orthodontics. This has been done in the belief that orthodontic care in the United Kingdom will be provided for the forseeable future by general dental practitioners, specialist orthodontic practitioners and consultant orthodontists. It is suggested that any reduction in the numbers trained would be outweighed by the improvement in standards.

In this paper the author acknowledges the importance to the aspirant specialist orthodontist of a 2-year period of basic specialty training, whether the orthodontist is going into an academic post, the hospital consultant service or whether he is going to limit his practice to orthodontics within the general dental services. He discusses the need to complete a period of general training in dentistry before going on to a 2-year course of training in orthodontics. This type of training should be given at a limited number of centres in university departments. During this extended period of basic specialty training the graduate is often under financial pressure. The need to pay the graduates who spend half of their time in a service role is stressed. The author discusses why Britain is moving into a situation in which in orthodontic training it is internationally in a minority of one and considers the dento-political background which has led to this. He is hopeful but pessimistic about the possibility of change.

A short history of the development of postgraduate education for the General Practitioner is given, together with information regarding administration of postgraduate courses and the development of postgraduate centres at District General Hospitals. Following graduation, the practitioner should be imbued with the idea that continuing education is a necessity if he is to keep up to date in his professional work. Incentives such as seniority awards or compulsory attendance for continuing registration are discussed. Personal experience in the development and organization of Orthodontic Courses for the General Dental Practitioner are presented, together with findings in other Regions.

Finally, future developments in organizing courses with particular emphasis on the part the Community Dental Surgeon may play are discussed.

The need for postgraduate education in an orthodontically undeveloped area is discussed with proposed methods of providing orthodontic instruction to practitioners and community dentists.

The general dental practitioner who is interested in carrying out simple orthodontic procedures may wish to associate with others of similar interests and to learn more not only from his own orthodontic consultant but from the consultants and teachers of other areas.

The need for continuing education is not confined to the general practitioner of dentistry. The specialist orthodontist generally welcomes new ideas but his isolation is even greater than that of the general practitioner. Facilities for refresher courses exist within the National Health Service and it is suggested that these should be of three types. Short symposia give an opportunity for the interchange of ideas between a large number of specialists. Courses of about one week's duration would involve limited numbers and might be either of a non-technical nature, concentrating on advances in orthodontic thought, or of a technical nature, teaching a new appliance.

This article completes a two-part series. Previously the control of lower second molars following loss of first molars was discussed. It is now proposed to describe methods of uprighting the lower second molar when the first molar is still present. The impacted second molar is typically mesio-angularly inclined and may also be rotated. The severity of the impaction is related to the type of treatment recommended but the methods described are not original. This two-part series is not intended to be a comprehensive account of the many techniques available but selected methods are illustrated by case reports.

Several methods of uprighting lower molar teeth are discussed. The method of choice depends on features of the individual case and partly on the type of impaction to be corrected.