Although an increase in demand for orthodontic care may seem like a blessing, one orthodontist is sounding the alarm on the growing issue behind it.
Bob Skopek, DDS, the owner of Skopek Orthodontics in Barrington, Ill., and Clearcut Orthodontics in Huntley, Ill., recently spoke with Becker's about how more general dentists providing orthodontic care could lead to more issues for patients and a higher demand for retreatment.
Editor's note: This response was lightly edited for length and clarity.
Question: What issue in dentistry is not getting enough attention?
Dr. Bob Skopek: So much attention is being paid to corporate dentistry and outside, non-dentist investors dictating profitability above patient care. However, a component of this that needs further attention is the pressure on general dentists to keep specialty procedures in house rather than referring them out to a specialist. Theoretically the more top line revenue the general dentist can produce themselves without referring it out, the greater their income, even if it results in marginal care rather than specialist-level care for the patients.
I am an orthodontist with three years of specialty training beyond dental school and a minimum of 50 hours of [continuing education] every year devoted entirely to orthodontics. Unfortunately, my practice has been booming the past few years and I am treating more patients than ever. Yes, you read that right. I’m not happy about my 25-year-old practice growing like crazy. I say that because I regularly retreat patients who have had "brand X or Y" of clear aligners and they can’t chew, have jaw joint discomfort or just don’t like the esthetics. These cases generally require a skilled clear aligner orthodontist, i.e. a specialist, to diagnose, treatment plan and execute the biomechanics. But they were kept in house with the generalist.
I have provided orthodontic care with Invisalign brand clear aligners since 2000. I believe clear aligner orthodontics is truly a subspecialty. There is entirely too much marginal orthodontic treatment being performed by non-orthodontic specialists, probably to the benefit of the financial bottom line but to the detriment of our patients and our profession.