I was elated to read the August editorial, “Pitching speed” (Behrents RG. Am J Orthod Dentofacial Orthop 2014;146:133-4), because that is what my provincial dental association is currently attempting to police in Alberta, Canada. As a general dentist (and subscriber to the AJO-DO ) who offers a range of orthodontic services and refers generously to my favorite orthodontist, I appreciate the opportunity to respond to the article and hope that many others voice their opinions both for and against your position.

We will both agree on 3 things: (1) patients generally prefer shorter times in braces; (2) if comparable results can be provided in a shorter time, this is better for the patient; and (3) there are real risks from dragging out treatment simply to collect insurance increments/payments or to “brand them” between phases.

I would also agree that companies need to use unbiased studies to prove their claims related to speedier treatment.

As an outspoken critic of “instant orthodontics” with porcelain veneers and the author of the banned book Confessions of a Former Cosmetic Dentist , I am not shy about laying out my opinion on breaches of trust with the public. The forces of the manufacturers and dental labs can put patient safety at risk, so maintaining a critical eye is important.

On the flip side, the option of “limited or shorter-term cosmetically focused orthodontics” on a continuum of choices should not be outlawed simply because sometimes the final result varies from the alternatives. It is excellent to treat to a certain high standard. As an orthodontist, one should argue for that with the patient, but not use these beliefs to attempt to use the dental association and college advertising bylaws to sanction the marketing of other choices that could be less expensive or faster.

In my case, I choose to use the registered trademark “High Speed Braces” to advertise shorter-term esthetically driven orthodontics (although I also offer all the other choices). Several local orthodontists have filed numerous marketing complaints and convinced the association lawyers that the mere use of those 3 words should be forbidden. To aid in my costly conviction, I have forwarded your article and anticipate that it will be used to limit my freedom to market this form of treatment (where I may use any combination of procedures, gimmicks, lawbreaking techniques, and inventions at my disposal).

It may surprise you that full-grown orthodontists have gone so far as to run negative attack ads on the radio, have produced belittling practice newsletters claiming that I had only a 2-day course in orthodontics, have attempted to have the orthodontic supplier cut off my supply of favorite brackets and wires, have told patients that high-speed braces wreck the roots, and have even threatened my staff. And one of these orthodontists used to get 2 or 3 referrals from me every week, so he chose to fight this disease of speedy treatment with great personal loss, although I hear he now offers AcceleDent (OrthoAccel Technologies, Houston, Tex) in his clinic.

The power of orthodontics has been underappreciated by cosmetic dentists (or should I say, dentists who offer esthetic dentistry?) during the last 20 years, but fortunately the tide is turning. My feeling is that patient care is enhanced by allowing patients the freedom to know their options and not by pretending that some options are good and others are bad. Thank you for allowing general dentists to subscribe to your journal and attend selected orthodontist association conventions.