I read with dismay the April 26 Business section article "Straight to market.” There is a general demeaning of the art and science that is dentistry, and now CVS wants to offer orthodontics to people.

There is much more to orthodontics than brackets, wires, and retainers. You are taking a part of the body and moving it through tissue. If it is not done correctly the teeth can be lost.

Before orthodontic treatment can be started a proper diagnosis must be done. A technician with a scanner cannot see the relationships of the upper and lower jaws to the rest of the skull. You need a cephalometric x-ray for that.

The technician and the scanner cannot assess the gums to see if the tissue is healthy enough to move teeth through it. You need a periodontal probe and a panoramic radiograph to do that. The dentist viewing the scan cannot assess these things through a scan. He must examine the patient.

Someone is going to be harmed by this and it is getting a pass for the sake of convenience and cost. Replacing teeth that have been pushed out of the gums by slipshod aligners is much more expensive than properly done orthodontic treatment.

Mark P. Small


The writer is a general dentist and fellow of the Academy of General Dentistry.