DR SAURABH PRAKASH
‘So Dr, what made you want to specialize in Orthodontics?‘
Well, specializing in Orthodontics is been a dream, not by a number of years but I would say it’s like my father was in the same profession, so I had been brought up among people with good teeth and bad teeth and by the time I joined my undergraduation, I realized yes, I do want to be an orthodontist, I used to love seeing people smiling with all their nice, lovely, beautiful teeth, so I was always passionate about this field and I used to love the science behind moving teeth and bringing them into a right position, so yes, that’s what made me go behind it. I would like to see people smiling. Everybody in the world should have a beautiful smile!
‘What are the challenges faced in pursuing Orthodontics and the most rewarding part of this field?’
Orthodontics usually, now, I have seen a lot of young doctors trying to learn orthodontics, it’s good because orthodontists in the world is quite less in number, so it’s nice to have quite a big team and it’s also very helpful. I’m very happy that they are trying to pursue and learn orthodontics, but one thing I would like to tell everybody is, you need to have patience. Orthodontics is not a treatment where you can just finish it, in a day or two, so you need a lot of patience, with the patients, because you’ll be seeing the patient for almost a couple of years, so yes, only the main thing first you need is patience. That’s the most important and hard work for any case you start, so that’s what I would like to say.
‘How do you stay up-to-date with the new treatments and advancements in Orthodontics? What are some of the new devices available for teeth straightening in the markets?’
Alright. As far as staying up-to-date is concerned, I attend almost every seminars, conferences, whatever that is possible and they keep you up-to-date. There’s a lot of good orthodontists and good speakers that come and talk over there and it’s nice to learn their experiences and it’s always nice, you just cannot stick onto the way you do orthodontics, it’s always nice to learn from other people and pursue. And now, in the markets, there are a lot of braces, a lot of different techniques to straighten up teeth, but ideally, you should be learning each and every one of them. They all are different in their techniques, it’s not like they are the same and you need to update yourself. You need to study about it. Even if you ask me today about orthodontics, “Do you know Orthodontics?” I’ll say, “Not yet, I’m still learning”.
‘You had developed research interests in both Geriatric Orthodontics and Obstructive Sleep Apnea(OSA). Can you share with us more about your research?’
Yes. I was quite keen on geriatric patients and recently, I have made my interest also in Obstructive Sleep Apnea, that is what OSA stands for. So when geriatric patients are concerned, yes, usually orthodontics, people see it as a young age treatment. When I used to see the parents coming along with their children, they were very keen on getting their children’s teeth corrected, their malocclusions corrected. So once, I happened to ask the parents, “Why don’t you go for it?” They said “No, no, no, they’re already beyond the age, so I don’t think so we can take up orthodontics”. So, I told them, no, it’s not like that, if your bone is healthy, your periodontium is healthy, you can actually go for orthodontics, and then, I started slowly doing these cases, and they went around telling people that yes, orthodontics can be done in adults, and they were waiting for good aesthetics. Who doesn't want to look beautiful? Everybody wants to look beautiful! So, they said, “Alright. If this can be done, we would love to get it done”. I have patients aging from almost 45 years plus till 65 years, and they come for orthodontics treatment. And, secondly, orthodontics treatment in geriatrics are not only for aesthetics, it’s mainly for functional, so sometimes you will get cases where they have teeth, very less teeth or very less number of teeth and they need a bridge or an implant, and because they have extraction done, their spaces get closed up, so with the help of orthodontics, you can actually give them what they want. So you can open up the spaces, so that they can get their implants or any other prosthetic treatments and I think it makes their life much better. And, as far as Obstructive Sleep Apnea is concerned, yes, I have recently started doing a lot of cases. Before Obstructive Sleep Apnea was mainly a forte for the ENT specialists, so they used to handle these cases but recently they have realised that, yes, they need dentists, they need orthodontists because they have started doing a mandibular advancement therapy with this, so now they’re doing a lot of meetings all around the world where all the ENTs, dentists and other specialties come together to treat these cases. And it’s one of the latest threat around the world, this Obstructive Sleep Apnea, so I think people should be aware of it. I’m trying my best to do, so let’s hope for the best.
‘How do you deal with difficult elderly patients who seek orthodontics treatment?’
I won’t say difficult elderly patients, I’ll tell them, they are in need. They are not difficult patients, actually they are patients who have a lot more patience than the young people, they don’t keep asking you, “ Dr, when are we finishing? When can we remove the braces?” They have the patience, they understand it much better, the only challenges we have with these patients are their periodontium, sometimes their periodontium is not very good, they have mobility in their teeth, they have bone loss, so you have to be very careful doing orthodontics treatment, so basically they are not difficult elderly patients, it’s difficult treatment what I would say. So, you need to be a bit more careful, when you’re treating such patients.
‘Is there a correlation between orthodontics and prosthetic dentistry? If yes, how are they related?’
Oh yes! As an orthodontist, I’ll say it’s not only prosthetic dentistry, I think because prosthetic dentistry is mainly for your aesthetics and all, but then I think beyond that, orthodontics is more of a multidisciplinary approach, so not only prosthodontics, I would say all the other fields is very much required in orthodontics. As far as prosthetic dentistry you’re asking, yes. As I said before, that sometimes the patient needs some bridges or some other prosthetic treatments or some implants and because of their missing teeth for a long duration, whether the tooth has supraerupted or either the tooth has moved, so, yes, we need to get them anything, all the occlusions should be settled. So, before they make them into a stable occlusion, in which, they can eat and they can live with. So, orthodontics, yes, it majorly helps with this, we can place back, we can give them an ideal occlusion, we can actually give them back their spaces, where they can do their prosthetic works.
‘What do you envision the Orthodontics field to be in the next 10 years?’
Oh okay! In the next 10 years, I believe, yes, the way the CAD/CAM has entered the orthodontics field as well, the braces are becoming more digitalised, there are other therapies like Invisalign and Clear liners which are very much computerised with the CAD/CAM things and all, so as far as orthodontists are doing, I’m happy as far as “machines” are doing in the next 10 years, I’m not shocked. But, yes, all I can see is orthodontics is rising, our teams are rising, and the more number of people who have understood that yes, orthodontic treatment is required for most of the people to stabilise their function, stability, aesthetics, so yes. Only thing I can vision is, we’re going to have a great orthodontic team and orthodontic treatment.
‘What is one accomplishment that you are most proud of Dr?’
Okay. I see myself down the line for almost 10 - 11 - 12 years. The thing I’m most happy about is, yes, everyday, when I’m doing my cases, I get to learn a lot, and same thing, I’m proud to say I can teach my students, alright, so that they can learn and they can go out and practice in the same way. So, whatever clinical experiences we get, that is what we teach them and that’s the most proud thing. So, I’m very happy and proud to be a clinician and an academician as well.
‘What advice would you give to current dental students who are interested to venture into Orthodontics in the near future?’
As I said in the beginning, you need a lot of patience to be an orthodontist. There’s no shortcut in orthodontics. There’s nothing like you know, you can finish, you can earn money. Please don’t see it as a business, alright, see it as hardwork, a work where you can make the patient happy, the patient can go out smiling, that’s the biggest achievement and that’s the biggest proud thing for you. So, please do not convert orthodontics into business and start thinking that okay, this particular field gives a lot of money. No, it’s not giving a lot of money to you. Basically, it gives satisfaction. You can face your patient after a couple of years when they have all their teeth still in place and happy, you will feel very proud of it. So, please don’t try to do any shortcuts, try to learn it, try to do it in the right way and follow the right rules.
‘Is it a myth or a fact that some young patients worry that if they do put on braces, the higher the chances they will lose their teeth early when they are old, because they feel that their teeth are moving during orthodontics treatment and are more mobile compared to people who have never used braces before?’
It’s absolutely a myth. Why I would say this is, you see when anybody comes to us even for aesthetics, nobody comes to the orthodontist and say that they have functional problems, nobody comes and say, “I have a Class II molar relationship”, nobody comes and say, “I have a Class III molar relationship”. They just come and say, “My smile is not good and my teeth are out”, something or the other the patient will tell you. But, we make sure that patients get the best of their aesthetics, but the most important thing is the function of your teeth. That supposed to be more stable, so we make it more stable rather than we make them mobile alone, as far as mobility is concerned, yes, sometimes what happens is when you do orthodontics treatment, there is mobility in the teeth, but as your treatment finishes, you are supposed to be on a retainer therapy, that is the time when actually the bone should start reforming and your teeth are supposed to be stabilised, so there’s nothing that the teeth moves. If you maintain your hygiene, if you are good with your brushing, I think there’s no mobility, there’s no periodontal problems. Secondly, we are making the occlusion more stable, it’s not like down the line, 10-11 years, their teeth will start moving or they will lose their teeth early. No. I think they are making their occlusion more stable, we are giving them a well-balanced structure, so I think they can live much longer because we are removing the traumatic type of bite, and everything, so it’s more stable that way. I believe that is completely a myth, so they should not feel like that.