Meeting the Challenge of Accountability
By Albert J. Repicci, D.M.D.
FEW EXPERIENCES IN life are as gratifying as being a part of the metamorphosis of floundering children into mature young adults. Likewise, few things are as frustrating and humbling. That is true for a parent and true also for an orthodontist.
From the vantage point of orthodontics, a profession intimately involved in both the emotional and physical growth of children, there is an opportunity to observe certain patterns of child development. On the surface, these patterns appear somewhat capricious. Yet, after 25 years of observation, they do seem to proceed with some degree of predictability.
If I were to propose one factor which motivates children above all others, I would be inclined to put a child’s desire for acceptance at the top of my list. With this in mind, I am occasionally drawn to the analogy between the term “school”, denoting a cluster of children engaging in study, and the term “school”, denoting a group of finned vertebrates groping through an aqueous abyss with the concept of sameness being pre-eminent for their survival. Fish, all of the same size and the same species, all equally spaced, all swimming in the same direction and at the same speed, do so as a matter of self-preservation to avoid drawing unusual attention to themselves by a would-be predator.
That we all feel comfort in numbers is certainly not a novel concept. It should not be surpris¬ing, therefore, that children find menacing circumstances, both real and imagined, more easily dealt with if the threat is confronted collectively, as in a school. Once children have achieved the sense of security which accompanies their acceptance by the group, they may venture outward with occasional forays of independence during adolescence—but never so far from the mainstream that they put them- selves at risk of rejection by their peers.
For those children who must address the question of peer accep¬tance relative to orthodontics, it is certainly true in the 1990’s that “braces” are socially acceptable. Lots of fish in the school are wear¬ing them! Ironically, we have reached the point where it is not unusual that an eager young patient, anticipating orthodontics, is disap¬pointed when an examination discloses that no treatment is required. In most circumstances, the health benefits as well as the self-confidence instilled by a pleasing smile take precedence over the inconveniences encountered during standard treatment.
Once treatment has begun, however, children become acutely aware that nature is an exacting task master. Young patients are often placed in a situation where they ultimately become responsible for the success or failure of their own treatment and must, therefore, confront the challenge of accounta¬bility. Nature and science have provided us with guidelines which, if adhered to, will yield a reasonably predictable result. If, however, a young patient violates the rules by not wearing “headgear” at night or not wearing “rubber bands”, for example, biological forces will prevail unabated and the case will be doomed to failure or to compro¬mise.
As parents we have been programmed to protect and to rescue our children. There is no one whose time is more utilized and less appreciated than the parent whose life is devoted in the service of “to time”. “To time” are those countless minutes and hours spent taking children to school. .to a sleepover…to retrieve lost or stolen items…to sports practice…to the library…to the movies…and, yes, to the orthodontist. Although many of these rescue missions may seem un¬avoidable and necessary, constant intercession ceases to be supportive. Our overindulgence may threaten to retard the child’s social and emo¬tional development.
During orthodontic treatment, however, both the parent and child must face the issue of accountabil¬ity. Both must accept the sobering fact that the child is engaged in a situation with potentially irrevers¬ible consequences in which he cannot be saved by Mom or Dad. The child is singularly challenged, therefore, to draw upon his or her own resources to render the case a success or a failure. Is it indeed any wonder that youngsters who successfully complete their treat¬ment regard the experience as a rite of passage into adulthood?
Ultimately, our children are probably much more resourceful than we give them credit for. They are also remarkably resilient when the foreboding spectra of the unknown is stripped away. As one young patient stated, “Just tell me how long treatment will take. Knowing that it will eventually end, I can endure anything.” As trying as parenting the adolescent may be, some solace can be extracted from his sage and courageous words. Knowing that the trials and vagaries of adolescence will one day end, we parents can, likewise, endure anything.