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Profile: jmailankody@gmail.com
User Name: jmailankody@gmail.com
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Joined: Sunday, May 14, 2006
Last Visit: Sunday, September 2, 2012 8:10:20 AM
Number of Posts: 8
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Last 10 Posts
Topic: Orthodontist as a team member-emphasised!
Posted: Saturday, August 1, 2009 9:21:04 PM
Once again a timely and relevant subject on JCO editorial July-2009."Team,Team,Team"! In the era of Adult orthodontics and interdisciplinary treatment approaches, one has to change the mindset and outlook.
While appreciating the points well mentioned in the editorial, I would like to add some of the excrepts from my lecture at the All India orthodontic Post-Graduate Convention, 2009 entitled "Adult orthodontics-Expectations,Challenges,and Possibilities: A realistic Overview."
By professional pedigree,(Angle) most of us are solo players and dwell in our own exclusive orthodontic practice circle.In a 'flat world' with level playing field(Thomas Friedman) one has to learn to be even or lesser member in a team. 'It is good to be in a team, it is still better to be in a winning team' should be the spirit. The hare and turtle story is retold with this message.
From the era of 'control and command' we have to reach out to 'communicate and collaborate' in the interest of better patient care.
The orthodontist has to shed his 'King of Jungle' ego and interact with specialists of other branches of dentistry with clear communication skills. This also demands a knowledge of what orthodontics can do and what it can't do-needing other disciplines to support, maintain and protect the health and integrity of the masticatory apparatus.
Even games like cricket have become totally team centred rather than individual centred. So also Hollywood and Bollywood!
Need of the hour for orthodontists to be 'Team playing'rather than solo performance.Many a situations orthodontist has to be 'second fiddler, or lesser one depending on the patient's problem.
Congratulations once again to Robert Keim, for a really worthwhile and contemporary piece of wisdom.
Jayaram Mailankody.
Calicut, India
Topic: Ectopic eruption of permanent canines
Posted: Saturday, November 22, 2008 9:00:31 PM
I do not know exactly what Ericson and Kurol stated and the full context. However, over years of experience seeing large number of retained deciduous canines and unerupted/ectopic permanent canines, we face a particular problem with the extraction of deciduous canines. Previously we used to extract explaining to the parents that the erupting canine would take path of least resistance, into the extracted space(?vacuum suction effect).
The parents become impatient to wait for eruption of the permanent canine. At times, when eruption does not happen, anxiety becomes comaplaint. 'The doctor extracted the well standing tooth expecting/promising proper eruption of permanent tooth- Wrong judgement?' In the contemporary 'defensive medical/dental practice' era and litigations under consumer protection act prevailing, I am afraid, we have a weak defense. There is also shift in view to extract severely malposed canines and replace it rather than saving it at whatever cost/Herodontics!
Jayaram Mailankody, Calicut, India.
Topic: Humanity above Profitability
Posted: Thursday, August 14, 2008 10:50:27 PM
Hullo Ron,
I agree with your right to disagree with my views. You are right for one thing, I work in a large Government teaching Institution with more than 25,000(Twenty Five Thousand) child births a year. Our tertiary care centre caters to a large number of cleft palate patients as well. I also practice exclusive orthodontics for the last 26 years.
I am really sorry, if I had hurt anybody.
My only rebuttal was that we should not be greedy Shylocks in the name of corporate, business management systems. That doesn't imply one should starve! Like life, there are easy and financially better rewarding cases in practice, and difficult with minimum margins of revenue. Only sweet with no bitter or sour cannot be reality in life.
I was also impressed by Ron Wolk's Guest editorial (Angle Orthodontist-July 2008) on the subject. So also Katz's letter in a recent AJODO. I would also like you to see my (unpublished) letter in response to AJODO editorial on commercialism.(sent as a seperate attachment to Ron Redmond)
Still, I respect your stand.
sincerely yours,
Jayaram Mailankody
Topic: Humanity above Profitability
Posted: Tuesday, August 5, 2008 12:30:55 AM
This has reference to the letters by Hayes and Haeger and also the editorial of July, 2008 issue of JCO.
First of all one has to admit that there is active debate on raising commercialism of doctors in general and orthodontists in particular.(Editorial AJODO:132:1) In the dot com era more and more clinical and therapeutic procedures will be vanishing from practice, in favour of more profitable 'modern'techniques. Corporate institutions are spending a lot of money on creating 'evidence' and getting it published in 'business friendly'journals! (advertising in the same journals.)
Secondly, cases like cleft palate will have less takers. Some years back, Adrian Becker lamented on the orthodontists' lack of interest in cleft palate discussions and treatment.(ESCO Digest)Are we loosing the humane element and compassion mandatory for a health care(?healing/Noble) profession ? In an excellent article'Orthodontics justified as a profession-' authors Rinchuse and Rinchuse(AJODO:121:1p93-96) have demonstrated that we have to continue to stay as Health care Professional.
Thirdly it is to be noted that many of our colleagues are joining the bandwagon of glorified beauticians' business domain. They float the concept of 'Social Six',giving the patient what they want rather than what is best(of course within our knowledge and experience)in the name of patient autonomy(against paternalism).
Unfortunately the three M's for the orthodontist choosing commercialism are Money, Marketing and Manipulation. Let prudence prevail to distinguish between the surgeon and the butcher, while making decisions on humanity and profitability!
Jayaram Mailankody.
Topic: Inclined plane
Posted: Tuesday, September 11, 2007 10:18:13 AM
Hullo Lael,
A good reference I can recommend you is Fig.133 and 134 at page 197-98 in the Textbook entitled "Orthodontics for Dental Students" by Gardiner, Leighton, Luffingham and Valiathan, 4th edition published by Oxford University Press. It gives the basic and simple design and there is a good text on its clinical application.
I am sure you would find it very useful.
Jayaram Mailankody
Topic: Self-ligating brackets
Posted: Thursday, August 31, 2006 8:00:44 AM
The recent CD on self-ligating bracket systems provided along with JCO's August issue was quite informative with marketing thrust. After watching it all carefully, one wonders: If only self-ligating brackets can respond to voice commands like "Open Sesame" and "Close Sesame", we can save a lot more chairtime. In addition, it will also dispense with the need for specialized instruments for opening and closing, avoiding contamination and sterilization. A few dollars' extra cost will definitely be worthwhile.
Jayaram Mailankody
Calicut, India
Topic: Treatment duration and research directions
Posted: Thursday, July 6, 2006 11:07:06 AM
Your editorial (JCO, June 2006) opens up two more important dimensions of orthodontics:
1. Methods to reduce the treatment duration need to be explored. The work by Liou and Huang on periodontal/septal distraction (AJO-DO 114:372-382, 1998) shows canine retraction (distraction) in 21 days in humans without any deleterious effects. This idea has been experimented with in India, in more than one center, and the results are encouraging.
2. The direction of research is usually linked solely to commerce (provider of funds) rather than patients' benefit or doctors' convenience. The market elements want to keep the control as well as the profits solely at their end, reducing the patient to a gullible consumer and the orthodontist to a mere vendor. They will diagnose, plan treatment, design and fabricate appliances, and ship them to the orthodontist for a fat fee. In turn, the orthodontist can add his "margin" and deliver the "goods" to unsuspecting/gullible patients. Isn't this true?
Topic: Two-way communication
Posted: Thursday, June 8, 2006 11:55:42 AM
Dear Dr. Keim:

You are to be congratulated for an excellent, timely editorial on the importance of communication in the orthodontic profession.

Whether it be with staff, patients, parents, general dentists, colleagues, other specialists, third-party insurance, social contacts, or the media--whomever one deals with, the key to success is in understanding the other and making the other understand us. The orthodontic profession largely depends on understanding and meeting patient expectations, and on obtaining good compliance and cooperation to this end. Therefore, it is mandatory that our postgraduate curriculum and examinations should have more emphasis on effective two-way communication. Very few orthodontic departments have communication modules in their specialty teaching programs. I'm sure your editorial and interactions during the AAO conference will further expand this vital subject into more effective platforms.

Another point in the editorial is to know and to explain why you are doing what you are doing. Here in our postgraduate program, the residents are programmed from day one to know and be able to explain: a) what they are doing; b) why they are doing it; c) why they chose that method over other available methods. This gives them the basic power to reason objectively, and to make others understand the rationale behind the procedure rather than following blindly like the pied piper.

Looking forward to more on similar topics in future.

Jayaram Mailankody
Professor and Head of Orthodontics
Government Dental College,
Calicut, India

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