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Interview: “The Olympics of orthodontics”

Dr Jonathan Sandler (Photograph Annemarie Fischer, Germany)
Daniel Zimmermann, DTI

Daniel Zimmermann, DTI

Fri. 11 September 2015

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Almost a decade in preparation, the International Orthodontic Congress (IOC) is set to return to the UK in two weeks’ time (27–30 September). Dental Tribune recently visited IOC chairman and President of the British Orthodontic Society (BOS) Dr Jonathan Sandler at Chesterfield Royal Hospital to talk about the London event and what it will bring to orthodontics in the UK.

Dental Tribune: The IOC is held every five years only. What are the advantages compared with annual events like the BOS’s own conference?
Dr Jonathan Sandler: I think having it every five years is good to build up the excitement and anticipation for the conference. We were awarded the contract back in 2006, so for me it has been a nine-year project really. I have assembled an amazing team of individuals, people I have run the British Orthodontic Conference with for many years, and I am very grateful to the whole team. It is like the Olympics of orthodontics.

The latest figures indicate that over 5,000 participants have already registered for the IOC. Does this number hold up to your expectations?
The bar for us has always been the 2005 IOC in Paris. That congress had about 8,000 delegates, so I hope we can get close to 10,000. As far as I understand, eight weeks before the conference in Paris, only 800 people had registered, so what we hope is that in the next few weeks delegates will keep flooding in.

We are in very good shape at the moment. The edition in Sydney had about 4,000 delegates, so we have already beaten the last IOC in 2010. Thus, we are quite confident that we can significantly increase our numbers.

How many participants do you expect to come from the UK?
There about 1,800 orthodontists in the country at the moment and I am certain the vast majority of them have signed up for the conference or will do so soon. While Europe remains our largest market, the Far East and Australasia also have a good share.

Orthodontics used to be centred primarily in North America and Europe. Considering the huge interest from dental professionals outside of Europe, do you see the specialty having gained importance in the rest of the world?
Definitely, everybody wants to go into the specialty. Until recently, for every orthodontic post in the UK there were ten applicants, so it is incredibly popular. It is also a wonderful lifestyle. Patients visiting an orthodontist as opposed to a general dentist are actually relieved or pleased if the orthodontist says he or she can do something for them, whereas everyone going to the general dentist hopes that nothing needs to be done at all. We are changing people’s lives on a daily basis, which is fantastically rewarding.

New short-term techniques have opened up the field for general dentists. What is your opinion on these developments?
I think one of the major concerns to all traditional orthodontists is the threat posed by short-term orthodontics. A lot of it is being done by people who perhaps do not understand the significance of the treatment they are prescribing or do not necessarily have an Option B that might be more comprehensive. Of course, there are situations in which a short six-month course may be appropriate and in such a case, I would be the first one to prescribe that treatment. However, I have to say that about 95 per cent of the orthodontics I perform takes up to two years, because that is the usual duration of a proper course of orthodontics.

There is certainly a great deal of concern about the plethora of short-term orthodontics courses that are being offered. There may be cases that are appropriate for a simpler line of treatment or a short-course fixed appliance treatment; however, it requires specialist knowledge to be able to assess the cases in which it would be in the patient’s best interest.

Do you consider this a negative development then?
Overall, I would consider this a negative development. There are a number of benefits from short-term orthodontics, but I am not sure that they are always moving in the direction of the patient. Commercial interests seem to affect the treatment plan increasingly and this is often to the detriment of the high-quality patient care that would otherwise have been prescribed.

Short-term orthodontics will definitely spark debate in London. What other topics will be discussed at the event?
The main congress will be held over three days. We will have 48 of probably the best orthodontic speakers in the world. In addition, short presentations will run alongside the keynote speeches. All in all, there will be up to 100 speakers at the conference, which will cover all the contemporary techniques, as well as some current research in orthodontics, so it is going to be an exciting programme.

One of the subjects that many will definitely find of interest is temporary anchorage devices, which will be covered in great detail. We have three of the world’s leading speakers on that subject, all of whom are from Germany or have German roots. Aligner therapy is also very current and increasing in popularity, particularly the Invisalign technique. Dr Timothy Wheeler from the University of Florida is a world expert, and he will give us a very frank and comprehensive interpretation of how he feels it fits into modern orthodontic practice.

Will the congress also look at the acceleration of tooth movement?
There will be scientific material presented about the AcceleDent technique that will allow attendees to draw their own conclusions. It is certainly an area in which people have great interest. There have been some worthwhile studies carried out and this up-to-date research will be presented. As far as I understand Prof. Martyn Cobourne from King’s College London will be speaking about this very subject, as will one of our arch-sceptics in orthodontics, Prof. Kevin O’Brien from Manchester. He is going to present his views on AcceleDent when he discusses uncertainty in orthodontics.

Digitisation has found its way into almost every dental specialty. Will the congress consider what its impact will be on the field in the future?
Intra-oral scanners are going to become increasingly popular in the next decade and clinicians are just starting to use them for collecting records for their patients. I am very keen to get intra-oral scanners here in the department over the next few months, so that I can start studying the Invisalign technique in more detail.

In my opinion, the use of these technologies is going to be one of the major changes in our field. A number of orthodontic laboratories are getting model scanners now, so that they can empty their model box room and store everything digitally. This technology offers a number of exciting possibilities.

Do you think it will have an impact on treatment processes too?
I am not yet convinced that digitisation per se is going to make significant inroads into improving the quality of treatment overall. This remains to be seen. There are a number of techniques now that are suggesting that one can set up one’s cases digitally, setting the bracket position or doing the finishing of the cases on computer and then have robots bend the archwires to produce the changes one would like to produce clinically. At the moment the jury is out, they sound wonderful . . . but do they actually deliver the goods. Clinically, it is still open to debate.

Will there be any other special sessions in addition to the main programme?
On Tuesday, we have World Village Day and we give the opportunity for orthodontic societies outside Europe to contribute to the programme with either a full-day programme, something the BOS is doing, or a half-day programme. We have the European Orthodontic Society, two Italian groups and our Chinese colleagues contributing, for example. All in all, we have 18 different groups contributing to World Village Day, so we really have the opportunity to hear from orthodontists from all over the world.

What will the conference bring to orthodontics in the UK?
This will certainly be one of the finest orthodontic conferences that the UK and Europe have ever seen. Specialists here will have the opportunity to hear 30 of the greatest orthodontic speakers, clinicians and researchers. It will give attendees massive exposure to world expertise and bring them up to speed. Participants can tick almost all of their continuing professional development boxes and will not need to go to another meeting for the next three or four years.

Thank you very much for the interview.

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