We were proud to crown Andras Iffiu ‘Orthodontist of the Year’ at our most recent {my}dentist Excellence Awards held in Birmingham. His commitment to the profession is undeniable and his patients are his passion so we thought we would delve into the world of Andras and his ortho career to understand why he doesn't just see it as a job...but a hobby!
Can you tell us a bit about your background?
I was born to a father who was the doctor of the Mines Rescue Service of my Hungarian coal-mining hometown. His closest friendships were forged at times of catastrophes, so I grew up among a crowd of idols: heroes with a can-do character, supreme focus and rationalism, utmost resilience and integrity and absolute loyalty. My mother is the most mothering of mothers, who still dedicates all her time and energy to her children and family peace. Always attentive and caring, she ensured our emotional wellbeing and upbringing.
What or who made you choose a career in orthodontics?
My love for sciences and people steered me towards medicine, but I felt I was much too a manual person so I chose dentistry. I absolutely adored University enjoying all aspects of dentistry (well, possibly endo the least), however, choosing a speciality was a tough call. Orthodontics is generally not particularly strong in universities’ undergraduate curriculum. Without sufficient exposure to it, potential candidates are unable to appreciate its depths and beauties. I consider myself lucky to have received a great boost of it during my Erasmus Scholarship at the Karoliska Institutet in Stockholm. After this I spent many afternoons shadowing Dr Horvath, the principal orthodontist in the nearby hospital, who solved orthodontic problems with remarkable ingenuity. I think I fell in love with orthodontics there and never looked back.
With hindsight I could not have made a better decision. I consider myself extremely lucky to be able to confess that my profession is my hobby. I never get tired of it: every case is a different riddle that requires revolving inventiveness and this keeps me going even at the end of a very long day. It is the perfect mixture of intellectual challenge, creativity and a dash of manual labour.
Of course, our patients are also responsible for maintaining our high levels of motivation: we love them and they love us back. It’s also great to have a laugh sometimes with patients and parents alike and I do think dealing with predominantly young people keeps one young at heart. While constantly doing one’s very best can be exhausting, it is, conversely, the ultimate recipe against burnout. Orthodontics is generally a very rewarding profession: creating contagious smiles is life changing; and that includes both our patients’ and our own lives!
What or who made you choose a career in orthodontics?
My love for sciences and people steered me towards medicine, but I felt I was much too a manual person so I chose dentistry. I absolutely adored University enjoying all aspects of dentistry (well, possibly endo the least), however, choosing a speciality was a tough call. Orthodontics is generally not particularly strong in universities’ undergraduate curriculum. Without sufficient exposure to it, potential candidates are unable to appreciate its depths and beauties. I consider myself lucky to have received a great boost of it during my Erasmus Scholarship at the Karoliska Institutet in Stockholm. After this I spent many afternoons shadowing Dr Horvath, the principal orthodontist in the nearby hospital, who solved orthodontic problems with remarkable ingenuity. I think I fell in love with orthodontics there and never looked back.
With hindsight I could not have made a better decision. I consider myself extremely lucky to be able to confess that my profession is my hobby. I never get tired of it: every case is a different riddle that requires revolving inventiveness and this keeps me going even at the end of a very long day. It is the perfect mixture of intellectual challenge, creativity and a dash of manual labour.
Of course, our patients are also responsible for maintaining our high levels of motivation: we love them and they love us back. It’s also great to have a laugh sometimes with patients and parents alike and I do think dealing with predominantly young people keeps one young at heart. While constantly doing one’s very best can be exhausting, it is, conversely, the ultimate recipe against burnout. Orthodontics is generally a very rewarding profession: creating contagious smiles is life changing; and that includes both our patients’ and our own lives!
Can you tell us about your practice?
I have worked for {my}dentist in two practices in Cambridgeshire for over six years.
Whitecross Orthodontics and Dental Care in St Ives is a one surgery two chair practice with a super enthusiastic and supportive young team, a very small NHS contract and a lot of private work. Beyond orthodontics the latter includes private general dentistry undertaken in my absence by Dr Jimmy Greyling and we also have a visiting hygienist, and periodontist/implantologist.
{my}dentist Hampton Court, Peterborough, is a 3 surgery practice with two full time general dentists making it a much livelier place. Despite this, thanks to my very loyal Orthotrac guru head ortho nurse, Louise Robinson, everything is organised like a clockwork.
I have recently taken up a small NHS contract in Old School House Orthodontics, a long-standing four surgery specialist practice in Kettering.
Can you tell us more about the ortho systems you use?
I mainly use old school twin straight wire appliances with bends where necessary. My private portfolio includes aligners (Invisalign), orthodontic mini implants (TADs) and lingual braces.
I do like to try new techniques. The problem in orthodontics is that it often requires a great deal of time to even see the results and thus to be able to compare them with existing methods in one’s armory. One should also remember to manage one’s own expectations: never give up, especially if initial results fail to impress; keep trying and improving and be patient. I particularly enjoy training in systems that compete with the ones I use as it takes you out of your comfort zone making you more alert and there is always a golden nugget applicable universally across different systems.
How do you think orthodontics has changed since you first started practicing?
While the NHS work remains, and predominantly will remain non pre-customised, we try to embrace digital dentistry where we can. Physical diary books, handwritten patient cards and referrals, analogue radiograph films, diapositives and plaster study models are obsolete. We use Orthotrac as a complete clinical, patient management and financial system. If the patient statuses, appointments, procedure codes and payments on the computer system are kept tidy, one can extract just about any information from the system in minutes.
Private patients may chose from various fully pre-customised braces where the braces are made-to-measure to their teeth and their particular treatment plan and outcome. This requires intensive planning, some of which can be done away from the practice.
I am particularly excited that intraoral scanners are expected in our practices in the very near future. This will speed up the services we provide and make our systems more streamlined and efficient.
My vision for the future is tailored braces available for everyone integrating intraoral and CBCT scans to visualise roots, but current IRMER guidelines (ALARP) would need to be eased to make this happen. Perhaps ever reducing doses may take us there one day.
Beyond the integration of digital methods I think the biggest changes are rising expectations from patients, colleagues and regulators, increasing litigation and consequentially defensive medicine. Changes in commissioning and retendering often means a lot of uncertainty and/or a tight squeeze for most and the end of NHS orthodontics for some practices.
Are there any products that you couldn't live without in your practice?
I do not think there are any products I could not survive without. Having worked in different countries in a variety of businesses, a multitude of practices and under a myriad of managements you learn how to make do with what is available. Of course, one has favorites beyond the self-evident essentials, just to name a few I love my TMA wires and a pair of quality torquing (Tweed) pliers for my finishing bends, boosters (turbo bites), a microetcher and of course a proper camera and associated photo equipment is also indispensable.[/vc_column_text][/vc_column][vc_column width="1/3"][vc_column_text css_animation="fadeInUp"]What do you think about general dental practitioners practicing short-term orthodontics?
Can you picture an endodontist who is upset that GDPs are doing root canal treatments? I don’t really mind. The great thing about short term orthodontics is that it makes the general dentist more ortho aware and thus more likely to refer cases to the specialist. Although I don’t call it that I also do it from time to time. Who does not enjoy having an easy case come their way now and again? I need a challenge though and without it I fear I would easily become bored.
General dental practitioners need to be mindful of the fact that short-term orthodontics is particularly affected by increased litigation and fitness to practice proceedings. The main issue is consent: Is the patient aware of the level of competence of the particular practitioner? Does the patient even know that there are specialists in the field? Has the practitioner offered the option of a comprehensive orthodontic treatment and/or a specialist referral? As long as the dentists are able to confidently assess what is within their skillset and they are able to deliver on their promises, they should be safe.
What are your views on direct-to-consumer orthodontics?
The biggest problem I see with direct-to-consumer orthodontics is that there may be no input from a dentist. A colleague of mine tried an online patient assessment tool, entered that he has periodontal problems and loose teeth and the system told him he was a great candidate for braces! I needn’t explain why this is dangerous practice and I expect there may be many more unseen or ignored pitfalls.
I doubt that the average person can take acceptable impressions of themselves or even their friends with a kit sent in a box. This has probably put an end to lots of enquiries, but I fear that the spread of digital impressions (intraoral scans) may accelerate the phenomenon.
I do expect an ongoing continuous rise of demand to rectify previous unsuccessful orthodontic treatment attempts, both from overconfident short-term-orthodontics and direct-to-consumer orthodontics.
How have patient expectations changed over the years?
Media and social media are the main drivers of a near insane rise in expectations of perfect body image in our patients. Youngsters are at particular risk and although this may prompt them to seek advice/treatment and also boost motivation and cooperation, it sadly also contributes to a rise in mental health issues including most worryingly self harm. Rising expectations are just a mild downside of the same. It is crucial, however, that unrealistic expectations are flagged and properly managed. I routinely ask my patients at their first consultation how they rate their smile on a 1-10 scale and where they wish to end up on the same scale. This is often diagnostic and also a good starting point to have a conversation if there is one to be had.
How do you relax in your spare time? How do you balance work and family life?
I recharge spending quality time with my beautiful and supportive wife, playing with the three gorgeous cheeky children she gave me, taking photographs on nice long walks and bike rides in nature. Playing music also switches me off completely. Because the amount of work I can undertake from home is very limited, balancing work and family life is a breeze.
Do you have any regrets?
No regrets, no.
What are your plans for the future?
I consider enrolling to an MSc course in lingual orthodontics to enhance my practice and perhaps one day I will attempt to become a member of the European Board of Orthodontists (EBO).