Orthodontic Fellowship in Trauma

[esclavo]

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I just used a kid's ortho to help me reposition psuedoavulsed #24,25. If it weren't for his ortho those little puppies would be in his lung or stomach. The whole time I am removing his old rubber bands and wire (I am swearing under my breath how much I hate ortho) then socking him back in and then using my new and improved (made up) orthodontic trauma skills to wrap very fine wire around his brackets to hold in my new wire. I thought to myself, why isn't an orthodontist doing this crap. What a waste of my time. Then I had the great idea of coming up with a fellowship in ortho...TRAUMA! They could use their little bracket-doohickies to help stabalize the teeth, they could sew the macerated buccal mucosa that those little doohickies cause... then reality hit me.... Blood.......ortho, local anesthetic.... ortho, I guess it would never work.... WAIT.... it could be an ortho assistant course, what am I thinking! What do you ortho's think of this? Your assistants could get trained. You wouldn't even have to get blood on your gloves! What an idea. Your assistant could give the local, reduce the teeth and then they could invite you into the room and sit you in a chair (so if you faint from the sight of blood you wouldn't fall too far) and show you what "you've" done...

 

[adamlc18]

I just used a kid's ortho to help me reposition psuedoavulsed #24,25. If it weren't for his ortho those little puppies would be in his lung or stomach. The whole time I am removing his old rubber bands and wire (I am swearing under my breath how much I hate ortho) then socking him back in and then using my new and improved (made up) orthodontic trauma skills to wrap very fine wire around his brackets to hold in my new wire. I thought to myself, why isn't an orthodontist doing this crap. What a waste of my time. Then I had the great idea of coming up with a fellowship in ortho...TRAUMA! They could use their little bracket-doohickies to help stabalize the teeth, they could sew the macerated buccal mucosa that those little doohickies cause... then reality hit me.... Blood.......ortho, local anesthetic.... ortho, I guess it would never work.... WAIT.... it could be an ortho assistant course, what am I thinking! What do you ortho's think of this? Your assistants could get trained. You wouldn't even have to get blood on your gloves! What an idea. Your assistant could give the local, reduce the teeth and then they could invite you into the room and sit you in a chair (so if you faint from the sight of blood you wouldn't fall too far) and show you what "you've" done...

Why would orthodontists wear gloves? All they have to do is point with their finger.

 

[BlueToothHunter]

Very nice of you to think of orthodontists! Orthodontists aren't meant to stick around in O.R. unless we're taking photographs of BSSO/IVRO or genioplasty! Otherwise we would start to charge for the time being there!

As an ortho resident, I've heard a senior resident having called out over the weekend to place surgical hooks on archwires at the request of OMFS. Apparently the OMFS residents weren't able to diagnose fractured bilateral condyles earlier in the week. They did finally figure out it was the fractured condyles (causing anterior openbite), after the patient came out of the radiology department at 11pm on Friday! So our on-call ortho resident had to go in on Saturday morning to put some hooks so that they could wheel the patient in for closed reduction. I guess it could happen now and then...

For the record, I was on-call over the Christmas weekend. I got one call from a patient asking me what should he do with a rubber spacer missing? I told him to come back to the clinic on Tuesday!! Oh, the other call was a wrong number!!! Boy, I do miss the 24/7 on-call I had to do as a house officer. Those were the days....

 

[gryffindor]

I shucked a slew of teeth today at work. At one point I actually thought "hmmm....I might miss this next year." Then I remembered that I can moonlight later in residency and have it all - straighten teeth AND extract the 4-bicuspid-exos I treatment planned.

I don't mind blood and sutures associated with oral surgery (it's the blood during crown impressions I curse). Although I think trying to put brackets on teeth in the Pediatric ER for any purpose would be difficult - no air/water syringe available. I do think every ortho resident should stand in the OR with the retractors to see what the heck goes on during an orthognathic surgery and follow up on the patient afterwards. If you plan to recommend orthognathic surgery to your patients, it would put some perspective into treatment planning. It won't happen though because most of the ortho residents would probably be on the floor minutes after the cutting started, either from the sight of blood or from the physical exhaustion of holding the retractors in place for more than 5 minutes.

 

[esclavo]

Very nice of you to think of orthodontists! Orthodontists aren't meant to stick around in O.R. unless we're taking photographs of BSSO/IVRO or genioplasty! Otherwise we would start to charge for the time being there!

As an ortho resident, I've heard a senior resident having called out over the weekend to place surgical hooks on archwires at the request of OMFS. Apparently the OMFS residents weren't able to diagnose fractured bilateral condyles earlier in the week. They did finally figure out it was the fractured condyles (causing anterior openbite), after the patient came out of the radiology department at 11pm on Friday! So our on-call ortho resident had to go in on Saturday morning to put some hooks so that they could wheel the patient in for closed reduction. I guess it could happen now and then...

For the record, I was on-call over the Christmas weekend. I got one call from a patient asking me what should he do with a rubber spacer missing? I told him to come back to the clinic on Tuesday!! Oh, the other call was a wrong number!!! Boy, I do miss the 24/7 on-call I had to do as a house officer. Those were the days....

Intracapusular "clam-shell" condylar fractures are almost impossible to diagnose definitively without a CT. Did you senior resident put on crimped ball hooks or Kobayashi ties? That OMFS resident should learn how to do Kobayashi ties, then he wouldn't have to wake up that poor ortho resident up! And it is better guidance with no wire distortion. You guys could give OMFS lessons in how to place Kobayashi wires! Save all that IVY loop time or arch bar time (save yourself from having to remove the wire). It is nice to know that "call" does exist for orthodontists... I guess. You guys could get another full time job with all the extra time in residency. Thanks to you and Griff for your input. One last question, if I decided to start my own orthodontist trauma fellowship (probably only be about a month long- 2 weeks reviewing local anesthetic and 2 weeks of tooth stabalizing techniques) how hard could I yell at them or berate them? I mean I just want to give them a good experience but I wouldn't want them to quit (then I'd have to do those resin wire splints-crap). So on a scale of 1-10 how much could I yell and scream at them-make fun of them? What is the ortho threashold?