A Voice in the Arena: Orthodontic Work Vs. Orthodontic Words by Dr. Chad Foster

Categories: Orthodontics;
A Voice in the Arena: Orthodontic Work Vs. Orthodontic Words 

by Chad Foster, DDS, MS, editorial director


A few months back, in my first column as editorial director for Orthotown, I discussed my respect for those orthodontists who are willing to publicly share their work through articles and online forums. I believe they are truly the men and women in the arena of our profession. Cases shared online, such as on Orthotown’s message boards and many Facebook groups, are arguably the most valuable clinical content available on those platforms.

While the value of sharing orthodontic words in the form of ideas, questions and concepts is extremely important, there is no doubt that the sharing of orthodontic work is a different sort of offering. Is there anything that offers a better learning opportunity— regardless of whether you agree or disagree with the treatment—than a full-record case outcome?

Those who share orthodontic work offer the opportunity for others to appreciate, discuss and critique real orthodontics. There’s not a more honest, vulnerable and worthy offering, no matter the particular treatment preference or bias. Doctors willing to share step out from the safety of anonymity and put their feet in the sand of the arena where things often get a bit … messy.

So, if we can agree there’s no content that’s more ripe for great discussions and learning opportunities than orthodontic work in the form of full-records case outcomes, then why are these offerings so relatively rare? It seems that there are two obvious reasons: the investment of time and the risk of criticism.

First, the time and energy required to post these types of cases in online forums is significant. For the busy orthodontist (all of us), time spent preparing records, formatting images, distilling one’s thoughts, writing and posting, then attempting to reply thoughtfully to feedback, is precious time that could be otherwise spent. Lack of time is the main reason we will unfortunately never know the work of many of the very best and brightest in our profession.

And then there’s the fear of criticism. Let me start by saying that criticism is the necessary and irreplaceable counterpart of shared orthodontic work. At its best, criticism can question, clarify, refine and sometimes reject the shared work. It can help elevate, evolve or inspire the next iteration of the work in question and thus in itself advance our profession. This type of invaluable constructive criticism challenges the recipients to be accountable for their actual word and the work presented.

There is, however, a type of criticism of a completely different nature, and it is the enemy of colleagues who willingly and openly share their work.

This type of criticism is not so much interested in professionally debating the actual word or work presented by the subject of the critique. With the goal of winning an argument with a caricature or “straw man” of their opponent, these critics are more interested in misrepresenting, conflating, ignoring context or even assigning viewpoints likely not even held by the person being criticized. Some go further to villainize the sharer’s motives, to claim that the sharer is taking an arrogant position of superiority by sharing, or to shame the original poster as not worthy of sharing in the first place.

Behind the anonymity of a screen and with the power of a keypad, it seems to become sport. This type of criticism does not seek to question, clarify or even intelligently nullify the work of the one who shares; it simply seeks to “win” by shaming and silencing the opposing viewpoint. It is truly a sight to behold as some of the brightest and most learned professionals in our society reduce themselves to the type of trolls who make regular appearances on public message boards.

Ironically, this type of criticism is most often wielded by those who rarely share their work because, in my opinion, those who do share their orthodontic work often have a more personal understanding of the humility and tolerance involved in this exercise. They more honestly acknowledge that even a well-treated case at its very best is itself always a composite of small wins and losses open for wide interpretation.

It is this lowest form of an intelligent critique that makes the sharing of orthodontic work, the most valuable shared offering, a rare bird on the many online orthodontic forums. Unfortunately, it’s also why much of the continuing education in our profession is done in the closeted safety of study clubs or professional organizations that are often nothing more than echo chambers of one-sided and unopposed biases and preferences—safe places where learning advances at a slower pace, free from all types of criticism, including the invaluable constructive kind. That is the practical tragedy of these critiques.

This is where the online forums hold so much potential! In my opinion, they offer the very best platforms for efficient, effective sharing of diversity of thought. I hope as time goes on we all benefit from greater sharing of orthodontic work of all types of treatment preferences and philosophies. Increased posts of full-record case outcomes and the professional debates and disagreements that ensue will benefit all of us. With combined effort, those willing to leave the safety of anonymity to share and those willing to be professionals in their critique will move us out of our insulated and political echo chambers and forward to the productive discourse that our specialty needs.

Verified members of the Orthotown community are free to share their thoughts and opinions in the Comments section under every article.


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