It was with great approval that I read the July editorial, “How good are you?” (Kokich VG. How good are you? Am J Orthod Dentofacial Orthop 2011;140:1). I am very much aware that regularly checking yourself is essential for good care, and this is different from passing a board examination. The European Federation of Orthodontic Specialists Organizations, an umbrella organization of national orthodontic associations and societies in Europe, has been active in motivating orthodontists to participate in its self-assessment system (ESAS), which is available online.

The idea for useful feedback from the ESAS is that annually a series of 20 to 30 consecutively finished cases will be entered and assessed. The patient satisfaction evaluation could also be offered to all patients to participate, since this doesn’t require any doctor time. Entering a full set of data for a patient (questionnaires for treatment outcome, treatment processes, and, eg, ICON as an index) takes only 7 minutes (for 20-30 patients annually, this would be less than 3 hours per year). Using indexes has been made easy in this self-assessment system because all calculations are done automatically.

An introductory video is available on the Web site, www.esas.nu , which offers basic information on how the ESAS works. The ESAS is available to postgraduate students as well. Their data remain in a separate database from the orthodontists’ data. In this program, a postgraduate student can compare his or her outcomes with others in the same school, and a school can be compared with other schools. Self-assessment is the key to quality in orthodontics.