Orthodontics in Hong Kong
The Hong Kong Society of Orthodontists represents all the orthodontists in Hong Kong. The Society only accepts registered dentists in Hong Kong who hold approved postgraduate orthodontic qualification to become a full member of the Society. Today there are 58 dentists who hold orthodontic qualifications in Hong Kong, of whom 55 are full members of the Hong Kong Society of Orthodontics. The Society also has 8 student members, 10 international members and 5 honorary members. Out of the current full members, 23 have been trained locally (42%) and 32 (58%) had undergone training overseas. The first groups of locally trained orthodontists graduated in 1988, whereas Hong Kong Orthodontists before this date were all were trained overseas. During the last 10 years, the number of full members have tripled, i.e. 28 new full members have been admitted, of whom 17 (61%) were locally trained.
The Academy of Medicine and the College of Dental Surgeons of Hong Kong are the statutory bodies in Hong Kong to approve and monitor specialists' training pathways, training centers, supervisors and trainers. They also approve and monitor compulsory continuous education for specialists, conduct examinations, vet specialists' applications and arrange continuous courses etc. The College of Dental Surgeons has 7 specialty boards, one for each of the six approved specialties and one for General Practitioners. Up to now, the College has 171 fellows, of whom 46 are orthodontists.
Orthodontic Practice Situation in Hong Kong
Out of the 55 full members of Hong Kong Society of Orthodontists Limited, 44 work in private practice, 9 work in the Government Dental Service and 3 at the University (10 members from the private sector hold part-time appointments at the University).
The majority of the colleagues working in private practice have limited their practice. At present, the private sector provides the majority of the orthodontic service for the community. Most of the private orthodontists work in solo practice, but a few also run two or more satellite offices.
The orthodontists working for Government Dental Service provide orthodontic care free of charge, almost exclusively for Civil Servants and their families. Only a small group of patients with congenital deformities such as cleft lip and palate patients are entitled to have free orthodontic treatment by the Government.
The Faculty of Dentistry of the University of Hong Kong accepts orthodontic patients mainly for teaching purposes, i.e. for undergraduate and postgraduate clinics. There is also a Cleft Palate Center that looks after about 500 to 600 patients. In addition, the three full-time orthodontic staff at the University also accepts private orthodontic patients on a referral basis.
Orthodontic Education in Hong Kong
The specialist training for any specialty in medicine and dentistry is six years in Hong Kong. It comprises two parts, basic and higher training respectively. After having completed their basic training in Orthodontics the candidates have to sit for the intermediate examination which is a conjoint examination conducted by the College of Dental Surgeons of Hong Kong, together with the Royal College of Edinburgh (Membership of Orthodontics). At the end of the higher training programme they are eligible to sit for the exit examination, and the successful candidates may then apply for specialist registration.
The basic training (in total four years), comprises of one year of general practice and active participation in continuous education, followed by a three-year full-time postgraduate training at the University leading to a Master in Orthodontics. The two years of higher training can either consist of two years part-time studies at the University leading to an Advanced Diploma of Orthodontics (in combination with supervised training in private practice), or two years supervised full-time training in an institution (Government Dental Service / University).
Research is a compulsory component of the Master Degree programme and the expected standard is one paper accepted for publication in a refereed international journal. The research project forms an essential intellectual exercise to train the future specialist to critically evaluate and analyze the current professional literature.
Continuous education is a compulsory requirement to stay on the specialist register. Over a three-year cycle, all specialists have to accumulate 90 credit hours on activities approved by the College. Failure to comply will lead to that the specialist being struck off from the specialist register. Continuous education locally is mainly organized by the College of Dental Surgeons, The Hong Kong Society of Orthodontists Limited, the University of Hong Kong and the Hong Kong Dental Association. In the future, it is hoped that an element of structured / competence-orientated course (conducted partly via IT or a practical 'hands-on' component) would be introduced.
The 'definite need' for orthodontic treatment is very high in the Hong Kong population, being nearly 40 percent among 12 year-olds (Wang et al 1999) and more than 50 percent among young adults (Hagg et al 2001). In 1992, among University freshmen only 4 per cent has previously had any kind of orthodontic treatment, which is considerably less compared to the 55 per cent of young Swedes who have had orthodontic treatment (Lagerstrom et al). This is a reflection on the current low awareness of oral appearance among the general population.
The low demand for orthodontic treatment has also been confirmed in a recent health survey conducted by the HKSAR Government. The population-wide Oral Health Survey conducted in 2001 by the Department of Health indicated that only 3.8 per cent or 2600 of 12-year-old students had received orthodontic treatment. It has also been shown that despite the proportion of individuals with severe malocclusion (which increases with age), fewer young adults demand orthodontic treatment compared to 12 year-olds (Hagg et al 2001). In the future, it is predicted that many more individuals in Hong Kong will demand orthodontic treatment due to the increasing public awareness and the improved accessibility to orthodontic treatment. The Hong Kong Society of Orthodontists Limited is committed in raising the standard of orthodontic service in Hong Kong and to educate the public to appreciate the importance of orthodontic treatment, as an integral part of the physical and psychological health of an individual.