Sir, in response to correspondence on GDP-delivered orthodontics, I fully agree that orthodontic treatment needs 'The right person, doing the right thing, for the right patient'. But instead of castigating GDPs for undertaking orthodontics, maybe we should be asking why this situation has occurred? And what is the solution?

In the early 2000s orthodontic undergraduate education was vibrant and engaged students in learning the necessary clinical skills.1 In addition, many consultants in the hospital orthodontic services ran 'extended attachments' which gave the opportunity for GDPs to learn orthodontics in a supportive educational environment. In the past ten years the amount of undergraduate orthodontic teaching has been reduced by the GDC undergraduate educational 'outcomes' in combination with pressures on dental schools. This has been compounded by VT and DF1 trainees having less orthodontic education than ever before. These opportunities have now fallen into the realms of history particularly with the increased access to primary care orthodontic specialists. Consequently, it is not surprising that GDPs can be easily mislaid by wild non evidence-based claims, more about advertising than dental science. The short term orthodontics (STO)/fast brace courses have arisen to fill that vacuum, and hence the marketing men have become involved.

We hear hyperbolic claims about 'fast braces' delivering 'fast (or STO)', although unfortunately osteoclasts and osteotblasts have not read the accompanying publicity. Any orthodontic appliance can deliver a quick fix as long as the problem is minor with small tooth movement required or the treatment plan accepts a compromise involving minor tooth movements. However, it is wrong to say these treatments are always inappropriate. Providing that the dentist and patient understand the compromises, limitations and informed consent obtained, and the need for lifelong retention (required with all forms of orthodontics), then that may be an acceptable treatment for a particular patient.

However, to achieve 'The right person...' approach requires orthodontic education now missing from undergraduate and immediate postgraduate education curricula. Thankfully a few enlightened orthodontic specialists are now working to educate GDPs in the necessary skills eg IAS Academy (I am the Training Director); Derrick Wilmot; Jonathon Sandler/Straight Forward, Straight Wire. Demand for orthodontics is increasing and without proper orthodontic education more GDPs will find that orthodontics is not just a quick fix.