On gardens, brackets and money

Understanding the scenarios of the orthodontic community in different countries may favor the political and administrative positioning of institutions involved with Orthodontics as a science. In the movie Being There (1979), Peter Sellers plays the gardener Chance. Living completely secluded in Washington D.C., what Chance knows about the world is what he sees on television. He entered into the real world due to misfortune and ends up joining an exclusive circle of powerful government men who strive for his “wisdom.” Brazil was once a huge garden. Orthodontists lived as gardeners “In the land of the blind, the one-eyed man is king” style. Suddenly, dark times came along, plagues and storms decimated all the splendor of the garden and darkness fell. Perhaps you might find this story a somber one, but I urge you to read on. Paraphrasing Nietzsche: “There are no facts, there are only interpretations.” Being an orthodontist in Brazil in the 1970s, 80s and early 90s was synonymous with social prestige, offices packed with patients and plenty of financial gains. There were few orthodontists, few specialization courses and an enormous demand for orthodontic treatment. Access to the benefits provided by the use of an orthodontic appliance was mediated solely by the ability to afford treatment and was considered a status symbol. In this context, the number of dental schools boosted from 90 to 202 in the last 10 years for a population of 200 million inhabitants. To put this into perspective, there are 280 million people living in the USA, and there was a decline from 65 to 58 in the number of institutions within the same period. Meanwhile, in Brazil, there was an indiscriminate proliferation of new specialization courses in Orthodontics associated with a veritable plethora of nonexpert dentists installing brackets without any type of criteria. The outcomes of all this was the popularization of orthodontic treatment in Brazil allied with the impossibility on the part of the general public in choosing a true specialist. Thus, treatment became more affordable, but with dubious quality; and a specialty once seen as glamorous began to be eyed with distrust.