An orthodontic education often requires rote learning. Dentists, for whom wholeness is so uniquely important, are almost distinctively un-whole, a remediable consequence of their training. Perhaps dentistry attracts individualists or encourages them to become individual in nature. Memory objectionably insists that even when the learning was without bias and restricted to a certain workload without prejudice, it was simply more esoteric in comparison to other brain functions.

The field of orthodontics incorporates the entire human existence. Whatever the reason, it can lead to unsuccessful behavior.

Doctors are great technicians with exceptional etiquette and skillful hands, but personal philosophy should be left outside the office door like his or her shoes, which for the same reason would seriously contaminate the realistic and theoretical nature of the business of orthodontics. Amid intense appearance of professional self-respect, there is an overriding theme: orthodontics is not about realistically and theoretically untainted business, but rather about individuals who are not pragmatically pure. Orthodontists are not merely concerned with protocols or techniques — they are infinitely more diverse.

In the past few years, communication skills have become essential parts of undergraduate dental curricula. That is admirable and noteworthy but simply not enough.

To recognize ethics and morality as a distinct subject implies that there are times when individuals act ethically and, accordingly, times when individuals act unethically. Ethics and morality do not exist in a box to be carried around like a knife or microscope and whipped out when required.

This might imply that ethics and morality are not intrinsic to everything that doctors do or say. Teaching ethics and communication skills to individuals who do not know what or why they believe is like teaching pathology to those who have not endured the experience of preclinical sciences; students might be very good at listing signs and symptoms or reciting the treatment protocols, but in practice they would be dangerous without understanding the fundamentals of why something occurred. Those individuals would be unable to modify or adapt their practice skills to new situations.

Teaching undergraduate students ethics and morality is not necessarily the answer. Teaching non-medical courses at the undergraduate level would undoubtedly be extremely helpful. There is no question the undergraduate curriculum is crowded, but if the only way to seed exhausted and bored brains with Plato or Aristotle is to sacrifice a detailed and utterly irrelevant knowledge of the origin and insertion of the flexor pollicis brevis, then by all means do it.

Perhaps more could be required at the stage of selecting dental students. Dental schools would most likely admit that all the serious candidates have “A” grades and that determining factors include other distinguishing characteristics such as being president of the debate team, captain of the baseball team or a spectacular interview. There is no doubt the academicians would be right, but maybe the problem is in getting the right candidates to apply.

Other criterion might be considered or required such as courses in civil rights, ethics and principles of social justice. The individuals who should be accepted may be those who strive to understand human beings and behavior, and only want to understand the DNA molecule or the function of cellular mitochondria because it’s a tiny but important part of the human cocktail. The moment someone sees the DNA molecule mainly as a money- or status-
generating machine, the brakes should go on! Orthodontics can be a self-perpetuating geek-ocracy.

Humanities and historians are other ascending disciplines, but until now they have been confined to the province of a beleaguered minority of those who read such epics as Victor E. Frankl’s “Man’s Search for Meaning” rather than those whose uncles were GPs. It needs to be understood for its own importance, receiving sycophantic tribute from the secondary disciplines such as physiology, neurology and cariology.

Accreditation should demand that doctors do not snore their way through a day of drug-company sponsored propaganda on new NSAIDs, but rather that they also attend their local book club or public interest groups. The patients’ best interests are wider than his or her “medical” best interests; they should insist that their clinicians who conduct those best interest resolves are doctors who work at more than just orthodontic techniques and their golf scores.

This is not a plea for a sniffily intellectual orthodontic salon ethos. It is not an assertion that orthodontists who listen to Beethoven at Lincoln Center are better people than those who listen to Gary Null over breakfast. It is a tentative suggestion that because Beethoven was and Gary Null is a member of the human race, knowledge of both of them are indices that the doctor is appropriately keeping up with the milieu of his or her profession via the need of the community and society.

Somerset Maugham wrote, “I do not know a better training for a writer than to spend some years in the medical profession.” The converse of this is also true: there are few better ways for an orthodontist to appreciate the scope of his or her subject matter than to keep the company of musicians, artists, writers and philosophers who have struggled to understand the nature of what homo sapiens are about and what makes them tick. True evidence-based orthodontics involves consideration of all available evidence about human beings and their place in the universe.

(This editorial was inspired by an original essay: Foster, C. (2009). Why doctors should get a life. Journal of the Royal Society of Medicine, 102, pp. 518–520.)