An interview with BOS president: Jonathan Sandler

orthodontics BOSBOS president, Professor Jonathan Sandler speaks to Dentistry Online about his desire to guide and support the next generation of orthodontists.

Fact file

Qualifications: MOrth RCS Eng 1988, DOrth RCS Eng 1986, MSc Lond 1986, FDS RCPS Glasg 1984, BDS Manc 1979.

Position: consultant orthodontist at Chesterfield Royal Hospital NHS Foundation Trust, president of the British Orthodontic Society, president of the Angle Society of Europe, contributing editor for the Journal of Clinical Orthodontics, examiner for the European Board of Orthodontics.

Publications: author or co-author of over 125 peer-reviewed publications

Clinical interests: finishing, temporary anchorage devices (TADs), twin block therapy, digital photography, teaching orthodontics at all levels.

Interests outside of dentistry: cycling, skiing, big boat sailing.

What or who made you choose a career in orthodontics?

JS: Having tried both general dental practice and oral surgery, each for a couple of years, I decided it was time for a ‘gap year’.

My friend, Kevin O’Brien, thoroughly disapproved of my dissolute lifestyle, teaching windsurfing on a beach in Paros. So, every month kept sending me the situations vacant section of the BDJ.

An advertisement to ‘Try Orthodontics at the Eastman’ appeared and the rest is history.

How has the BOS changed in the last 10 years?

JS: Under the chairmanship of Nigel Hunt the society was significantly restructured to comply with guidance from the Charities Commission.

We now have a board of directors, each director is a trustee who takes responsibility for a different aspect of our activities. We are putting a large amount of effort into engaging more with our patients.

In the last few years we have produced many patient-centred publications and videos. We now also have a patient panel who provide us with advice on consumer issues.

How do you think orthodontics has changed in the past 25 years?

JS: When it comes to techniques, I have certainly been very happy to say, I have significantly reduced the numbers for whom I prescribe headgear. I never liked fitting headgear for patients and although in a few incredibly well motivated patients it can produce remarkable changes, for the majority it is truly an uphill battle.

Instead I now prescribe many more temporary anchorage devices (TADs), which has also been one of my key research interests.

Lingual orthodontics reared its head in the early eighties then died a death. Now, it has reappeared in the last 10 years and is a serious contender.

I would recommend all trainees learn a lingual technique that they are happy with. They need it as part of their armamentarium. I am certainly giving my trainees at least a taster of lingual appliances during their training.

The same applies with aligner therapy. A few years ago, this was considered one of the ‘dark arts’. Today it forms part of mainstream orthodontics. We have introduced some training into the programme for all of our trainees. They now get their own aligner patients to treat so they are prepared for the primary care challenges ahead.

Can you tell us about all your current roles?

JS: Where do I begin? I have been at Chesterfield as a consultant orthodontist for more almost 25 years. The hospital has been incredibly supportive of all my endeavours. I have always been a single-handed consultant, which suits me perfectly. The opportunity arose to influence the clinical training of my two registrars and senior registrar to a significant degree. I also have three qualified specialists (Ajay Patel, Dave Tinsley, Jon O’Dwyer) who come into the department and contribute greatly to its’ success.

Also, I work with the three nicest maxillofacial consultants in the country. This has made work a total pleasure for my entire consultancy.

In addition, I have been running hypodontia clinics with restorative consultant Ian Harris, and friends Dave Tinsley and Jon O’Dwyer for well over 15 years. Together we have provided implants and bridges for some of the most challenging orthodontic patients in Chesterfield.

Outside of working hours I carry out my other roles as president of both the Angle Society of Europe and of the British Orthodontic Society.

I am one of three UK diplomates of the European Board of Orthodontics and as a consequence I have been a European Board of Orthodontics examiner for the past five years.

For the past seven years I have been co-presenting the ‘Art meets Science’ course with Professor Kevin O’Brien. We shared a house as undergraduates in Manchester in the seventies, and have been friends ever since. Our careers followed similar paths both spending time in the USA. Also, teaching and lecturing all over the world but ending up working pretty close to home.

Are there any clinicians who have inspired you?

JS: I feel honoured to have known and been inspired by some great teachers.

In the UK the first to show me ‘the fun of orthodontics’ was Ray Reed. I had the privilege of working with him only for one day per week for a year. However, he influenced the whole of my approach to orthodontics, from that point onwards.

My in-depth clinical training was provided by the late, great, David DiBiase, who was the finest clinician and teacher of his generation. We worked together for five years during my extended senior registrarship at the London Hospital and in Southend. During this period Bob Lee massively influenced my approach to managing both maxillofacial consultant colleagues and hospital managers. This is a skill without which my life might have been very different.

The late Vince Kokich and Sverker Toreskog were both an enormous influence. They taught me many aspects of how to effectively teach clinical subjects. My friend Kevin has guided my research career for the past 25 years. I owe him a debt of gratitude for keeping me interested in the research aspects of orthodontics.

What are your views on short-term orthodontics?

JS: I naturally welcome all innovation and progress. Some of the newer orthodontic systems have made claims that have been weighed up by Kevin O’Brien in his blog…and have been found wanting.

I would like to think that this tendency for over-enthusiastic marketing will eventually be modulated, both in the interests of the profession and its patients.

The increasing interest in our specialty is certainly positive, but dentists who invest in short-term orthodontics should get the necessary support and instruction they need so they know not to step outside of their ‘comfort zone’ and first and foremost ‘do no harm’ to their patients.

All practitioners who want to develop their skills in orthodontics are warmly welcomed to join the BOS.

You’ve had a fruitful career and many achievements – what do you think is the secret to your success?

JS: Orthodontics is one of the most rewarding specialties in every sense of the word. If you put in the work, you gain the respect of colleagues and success follows.

Through being fortunate enough to work with so many inspirational colleagues, many of whom I now consider close friends following my annual visit to the Angle Society of Europe over the past 25 years, I have always had a passion for clinical orthodontics.

Even after 33 years in the specialty I find each and every patient encounter fascinating, and I continue to learn about orthodontics on a daily basis. I have also been fortunate to work with some great teachers who have passed on the bug to teach.

Invitations to teach, from all over the world, have just kept arriving and Alison, (my predecessor as president and incredibly supportive wife) and I just keep saying ‘yes’.

How do you stay abreast of modern techniques?

JS: I am fortunate that I can stay ahead by virtue of what I do. The Angle Society meeting is a ‘dry run’ for the ‘cutting-edge’ techniques that are about to appear in all other international orthodontic conferences that year. Dental supply companies, and particularly American Orthodontics with whom I’ve worked for the past 30 years, invite me to try out all the new products so that I can feedback to them at the earliest possible opportunity.

Then of course there is the British Orthodontic Conference, the best place to learn about the latest research, innovations and clinical techniques in orthodontics!

Where do you get your motivation and drive from? 

JS: Currently I am driven by a desire to support the next generation of orthodontists.

I want to try to ensure they have all the opportunities that were provided for the current generation who have had the most amazing professional lives.

This article first appeared in Orthodontic Practice magazine.

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