Diagnostics-Driven Orthodontics: The Real Driver for Progress

There is nothing so useless as doing, efficiently, that which should not be done at all.

Peter Drucker

The concept that mere technological innovation in a certain field can drive rapid progress within that field is not a new concept; and this has certainly been accepted as “the norm” in this era of rapid – or shall I say rabid – pace of technological innovation in both the medical and dental field in general, and Orthodontics in particular.

That’s all well and good, and is much appreciated and needed, of course. However, it seems that – despite all the advances in dental technology over the past decade or so – many practitioners seem to be suffering from what we can only term: Diagnostic Paralysis. This lack of diagnostic skills in this era of rapid technological advancement is alarming!

Let’s have a closer look at this in this blog post.

The whole notion of sound, ethical and beneficial treatment is based on one thing – and one thing only – that is; Proper Diagnosis. Once a proper diagnosis has been reached, the rest is simply about following certain pre-determined treatment protocols, utilizing available technology and appliances in order to achieve the desired outcome. Here, the skill of the dental practitioner is of paramount importance for the proper and efficient use of this technology at hand. This is THE basis for medical and dental practice, and always will be.

The art of progress is to preserve order amid change and preserve change amid order.

Alfred Whitehead

The problem starts when we prioritize the use of new technology over actual thinking , and we become addicted to the latest technologies all the time to the extent that we do not give ourselves a chance to even master the previous technology or appliance before buying the next big thing, just for the sake of it! We always remain on that initial upward slope of the Learning Curve and never get the chance to fully master it or even reach a plateau stage, after which many new breakthroughs in our understanding of the technology at hand may be reached. In addition, the true limits of that technology will be obvious to us by then as well.

Hernandez et al : Robotic Lobectomy: flattening the learning curve. J Robotic Surg (2012) 6:41–45

Sadly, the current focus seems to be on simply getting new appliances and technologies rather than mastering when and how to use them for maximum benefit, and in the right situation ! (see Peter Drucker’s quote above).

As long as we keep prioritizing technology over proper understanding and diagnostic skills, any perceived advancement is merely an illusion. Companies and products marketers may sound the propaganda that without their “new and advanced product”, our practice will be lagging behind, but if there is no real, long-term understanding of the technology being used and emphasis is only on the “WOW” factor of appearing to have the latest shiny gadget without a real diagnostic skill substance to back it up, the treatment results – and ultimately the practice – will suffer.

Vin Clancy

The antidote to this problem is simple; One should take a step back from all the hype and marketing and focus on building and improving one’s diagnostic skills first and foremost, supplementing that with whatever technology we may deem necessary within the current range of our competence and skills, and slowly build from there.

Craving and buying the latest technology as soon as it is launched in the market is not a sign of progress, it is only a sign of – you got it: craving!.. Craving the new before knowing even how to make good use of the old, and that’s a perpetual game that has no end, unless one can see the light!

In a very useful course about Digital technology in Orthodontics that I once attended in Budapest, Hungary, Dr. Guido Sampermans said the following:

Our profession is driven by diagnostics, not appliances. Always remember that.

Dr. Guido Sampermans

I totally agree with his statement. I’m sure some may have a different perspective here and I’d love to hear it in the comments section for the benefit of all.

Let’s keep aiming for diagnostic mastery utilizing the tools at hand, and progress will surely follow.

9 thoughts on “Diagnostics-Driven Orthodontics: The Real Driver for Progress

  1. Thought provoking post! You can have all the gear and still no idea. Diagnostics is indeed a slippery slope and even when you think you’re at the top, you’re probably about to plummet in the ‘discouragingly realistic’ valley. Thank you Dr Samawi.

    Liked by 1 person

  2. Digital technology can make a good Orthodontist better but it cannot make a bad Orthodontist a good one.
    On the other hand it’s not the strongest species nor the cleverest but the species that easily adapt to the changes


  3. On the other hand it’s not the strongest species nor the cleverest that survive but the species that easily adapt to the changes(correction of the previous comment)


  4. As we have seen by evaluating Smile Direct results, the availability of technology does not equate with quality care. We need booth. We need the knowledge to address all of the intricacies of our chosen profession, and we need the fine-tuned appliances to do it with. it is important to note that removable trays are less effective at achieving sterling results than fixed appliances, no matter how talented and knowledgeable the practitioner. We can strive for excellence, or we can accept mediocrity. It is ethically important to fully advise the patient that although both fixed and removable appliances have improved over time, they are not equivalent.

    Liked by 1 person

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