Download Dr. Robert Bray 401 N. Lindbergh Boulevard St

Dr. Robert Bray
401 N. Lindbergh Boulevard
St. Louis, MO 63141-7816
September 24, 2010
Dear Bob,
At our recent Legislative and Governmental Affairs Council meeting, we noted several concerns
relative to the gp/orthodontist referral relationship on the web site www.braces.org. Our purpose
with this communication is to bring to your attention AGD’s and the gp’s concerns on how these
statements hinder the relationship between gp’s and specialists. We hope that you are able to
address our concerns so that the referral relationship can prosper.
Section entitled Myths and Facts
Myth #2 – My family dentist says he can straighten my teeth. AGD’s concern: Some general
dentists, especially more experienced ones like AGD’s Fellows and Masters perform hundreds of
orthodontic procedures each year. It is regretful to paint all gp’s with the same broad brush. In
addition, as you are aware, restorative care can be much more complex than orthodontics. To
imply that “drilling and filling” is mundane is demeaning.
Myth #5 – Orthodontists charge more than general dentists for orthodontic treatment. AGD’s
concern: As you know, the fee structure depends upon the complexity of the case, not on
whether the dentist is a general dentist or an orthodontist. It is the same work and must be
performed to the same standard of care.
Section entitled Ask Your Dentist
Question #4 – Have you had orthodontic training beyond dental school, etc… Surely AAO
values continuing education and is not suggesting that once an orthodontist completes his or her
residency, he or she is competent for the remainder of their practice career? Likewise, the broad
range of orthodontic continuing education available to the general dentist can make that dentist
just as competent as the specialist, when he or she chooses to perform that type of orthodontic
treatment, consistent with the ADA (and AGD) Code of Ethics.
Question #10 – Are you a member of the AAO? Membership, in of itself, does not make a dentist
a good practitioner. (Cf. Nova Dental School)
Section entitled Ask Your Orthodontist
Dr. Robert Bray, Page 2
Question #4 – Have you had training beyond dental school?.... General dentists who avail
themselves of quality continuing education are earning certificates of completion.
Question #8 – Which cases do you refer to dentists? AGD maintains that that if restorative
procedures are needed, then the orthodontist must refer to the general dentist.
It is AGD’s most sincere hope that we can work together to foster a mutually beneficial referral
relationship. We take these steps when we meet together in forums such as the ADA annual
session. In this particular case relative to the promotion of the orthodontist, AGD will be most
happy to work with AAO in ensuring that the most accurate language is promoted to the public
and that the public is made to understand the true nature of the referral relationship between the
specialist and the gate-keeping general practitioner.
I would be most happy to discuss this further with you at our mutual convenience. Please
contact me at 248.398.7880.
Sincerely,
Fares M. Elias, DDS, JD, FAGD
President
CC:
Mr. Chris Vranas, AAO Executive Director
Mr. Charles Macfarlane, AGD Executive Director
AGD Council on Legislative and Governmental Affairs