An occasionally irregular blog about orthodontics

I have decided to become an orthodontic quack and snake oil salesman!

I have decided to become an orthodontic quack and snake oil salesman!

I have decided to become an orthodontic quack and snake oil salesman!

I have always been interested in orthodontic developments that may not be considered to be mainstream. These are often promoted by practitioners who consider themselves to be “mavericks” or “great thinkers”. I have debated their techniques many times with them with limited success. So I have decided to join them and develop my own treatment and surround it by the “smoke and mirrors” used by the orthodontic quacks and snake oil salesmen.

images-24I have developed a new treatment called orthohydrotonics. It is a removable appliance that is connected to a tank of water that is attached to the patients back. Water flows through the appliance. This massages the muscles and encourages them to develop, the flow of water also influences the electro magnetic waves that pass through the muscles and teeth making the teeth move faster. Finally, the tank of water pulls back the shoulders and improves neck posture leading to improved breathing and preventing long term spinal degeneration. So these are steps that will I take to promote this treatment:

 Develop a new disease.

This will be called craniofacial-osteodental dysplasticum. or COD. I will redefine some of definitions, for example, increased overjet can become Class IX COD.

Diagnosis

I will need a new cephalometric analysis and CBCT analysis to identify the unique features of the disease. Ideally, COD can only be diagnosed by CBCT.

 Think of a new name for my special orthodontic treatment. 

I will call this Cranial Release Aquatherapy Provision.

 Start educating

Schoo in the North of England

The North of England, School of Cranial Facial Aquatherapy Provision

I will start a short diploma course at the North England School of Cranial Release Aquatherapy Provision. I will advertise it to interested general practitioners and specialists. They will become Diplomates, Masters and Grand Masters in Cranial Release Aquatherapy Provision.

 

Develop Information.

I will prepare information and course material that simply underpins my new treatment. If I use references, I will dig out some old ones that support my treatment. Importantly, they will be so old that they do not stand up to contemporary scrutiny. I will quote them as the “truth” to course delegates.

 Set up a Website

I will set up a series of websites to promote Cranial Release Aquatherapy Provision, along with a Facebook page. I will get some poorly documented case records and only provide limited details on my therapy and results.

 Criticise other orthodontists.

I need to state that orthodontic treatment provided by other specialists is “traditional”. This will make Cranial Release Aquatherapy Provision more attractive. Then I will expand on this by claiming that Universities and training programmes teach that most orthodontic treatment is based around extraction therapy. I will then follow this up and claim that those who run the training programems are in a conspiracy to deny orthodontic knowledge.

 Resist challenge

I will be challenged to provide evidence for my treatment and philosophy. Firstly, I will not respond. Then when I am challenged further, I will misquote my collection of carefully selected old papers. Finally, I will argue that it is not possible to measure the effects of my treatment and philosophy.

 Become a maverick

I will call myself a maverick and free thinker.

 Completely dismiss research evidence

I will not believe, or totally ignore, any trials or systematic reviews that do not support my treatment. If this is pushing it a bit, I will just state that my treatment cannot be trialed.

 Resist debate

When pushed I will raise multiple side issues that are not concerned with my treatment and build as much confusion as possible around my treatment, courses and philosophy.

If this is successful we will gain sufficient moment around the  new treatment and philosophy. Most importantly, I will have built a critical mass of followers who believe everything I say and do without question.

What do you think? Will this work? Could I sleep at night?

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There Are 58 Comments

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  1. Ross Hobson says:

    Please can i apply for you Special Higher Intensive Training in CRAP? I have long wished to become A Sub Specialist Holding Onto Limited Expertise
    I will to send monies via your Nigerian bank account

  2. Ross Hobson says:

    Kevin – i bet my post gets a NO…..
    great blog post, laughed my head off!

    • J R Williams says:

      Kevin is too smart for that. If his treatment included epigenetic effects, within one generation, there would be no more malocclusions to treat

  3. Nicky Stanford says:

    You forgot the epigenetic changes evoked by the treatment.

    The epigenetic effect of any treatment is always VERY important!

  4. Jim Page says:

    Thanks Kevin
    Can I ask how much you propose to charge for this new and exciting treatment and could I please apply for a franchise?

  5. Klaus says:

    Dear Kevin,
    I think you will be very successful in selling as many others we know, but very frustrated in science. As I know you well, you’ll not be able to sleep at night. So, please don’t do this.
    Seriously, you wrote a protocol very familiar for us.
    Best wishes,
    Klaus

  6. Ann Larsen says:

    I love it!

  7. Yes, your scheme err I mean business plan will work! The evidence is there to support this. However, I can’t say if you will sleep at night. Perhaps you should do a sleep study. If it turns out that you are not getting restful sleep, I recommend you sleep with your new orthohydrotonic device. I’m certain that will do the trick 😉

  8. Nur Ariff says:

    Hi Kevin.
    Sign me up. Would love to add more alphabets behind my name. “GM in CRAP”. “NESCRAP Alumni” car stickers, anyone?

  9. Should have saved for April 1. Thanks for the laugh!

  10. Don’t give up your day job. You’ll never make it in the humour stakes.
    What you wrote says far more about who you are than anything or anyone else.
    It was not even vaguely funny to anyone who actually understands cranial structure, soft tissue dysfunction and the fact that orthodontics is not just about STRAIGHT TEETH.
    Where is the published science that malocclusion is genetic?
    Where is the published science thats says a child has Mom’s jaws and Dad’s teeth?
    How can anyone with a shred of intelligence believe that the loss of 25% of one’s teeth will have no impact on their function?
    How many people who have had bicuspids removed have also had to have 3rd molars extracted?
    Just because something is commonplace doesn’t mean that it is normal, natural or correct.
    Many people doing the ‘wrong thing’ doesn’t make it right.
    Remember the immortal words of John Maynard Keynes – the British economist.
    “It is better for the reputation to fail conventionally than it is to succeed unconventionally”

    • Kevin O'Brien says:

      Not sure that I mentioned any of the questions that you raised? It seems that you believe that extractions cause harm. Have you any proof?

      • J Williams says:

        Kevin, It appears you’ve hit a nerve. Some folks are very sensitive to being called to account

      • Jennifer says:

        Given that the teeth erupt naturally and extracting them is the intervention, the burdon of proof for safety and improvement is on whoever is supporting extraction. We are born with those teeth for a reason. You better have solid evidence of no harm and proof that there is benefit if you insist on removing them.

        • Kevin O'Brien says:

          Thanks for the comment, I have addressed extractions before on this blog. There is no doubt that some patients with severe crowding need extraction, as part of a course of treatment. However, it is not the extraction that may cause harm, it is the choice of treatment mechanics.

        • Rob says:

          Well balanced , well considered comment , that Kevin’s response avoids address , by employing a tactic he mocked in his article …
          all very funny !!!

      • Arhimed says:

        Same thing happens when a patient loses teeth due to complications of decay. Is that harmless?

  11. i will steal your idea and also improve it. tank will now be worn while in a swimming pool at least 12 hours per day to super maximize the effect. i have applied for patents so you will not gain monetarily from my invention. i will pay you to model the appliance at trade shows while in a small pool. have your lawyers call mine. deal ?

    p.s. thanks for all you do for our profession

  12. Andrew Adey says:

    Don`t you use herbs to move teeth? No? How disappointing.

  13. Jimmy Vaden says:

    Kevin–Fantastic. I need to register to take that North England Course!! Problem is that orthodontics is not far from what you so well described with your tongue in your cheek. We have plenty of these snake oil salesmen and they are proliferating at an alarming rate. Loved it!!

  14. Hello Kevin. I hope your ‘tongue-in-cheek’ blog listing is not an indication that you are closed to ideas other than the ‘traditional’ teachings of yesteryears. I don’t believe that you are, but how unfortunate for those who hold onto treatment that was not always in the patient’s best interest. There are many traditionalists out there who still just work on just getting straight teeth and really don’t understand some of the long term health repercussions of their tooth centered treatment. Those consequences can include significant TMJ dysfunction, obstructive sleep apnea and even spinal alignment problems which can all be avoided with thoughtful treatment. I personally have retreated hundreds of orthodontic ‘results’ who have sought out my help to correct their present oral dysfunction. It is time we thought about the effects beyond the mouth for our treatment! Just saying.

    • Kevin O'Brien says:

      Hi Kent, thanks for the comments. I would like to reassure you that I am not closed to new ideas. However, I would like to see these new ideas supported by research evidence. At present, there are too many developments being sold to practitioners and patients. I do include things such as self ligation and vibration in this list.

  15. Claude Stephens says:

    You have a great sense of humor. I do believe CRAP therapy would work in terms of sales to the gullible but I also know you could not sleep at night.

  16. Haris Khan says:

    Dear Kevin great post but lets face it,its the reality. Some of us make our earning from our institute,some of us from patient and some from fellow orthodontist or more generally from dentist. the easiest way to earn from dentist with interest in orthodontist is to tell them that what ever that learnt during graduation was wrong or too complex. unfortunately these commercial orthodontist have the funding to attend every conference, personally know journal editors ,open a website and pay for Facebook liking. In AAO conference 2016 a superman from Taiwan claimed that he dont believe in evidence ,he make his own evidence and publish it in his own journal.
    if you start doing it what you said definitely it will work. But we all are prisoners of our own soul. A commercial orthodontist can sleep after doing all this bcz he thinks he is doing the right thing for earning money but i think you cant otherwise you wont have written this post.

  17. Tony Ahmed says:

    What a hoot, love it!

  18. Fenris Ulfr says:

    But Dr. O’Brien, what about iatrogenically increasing overjet to 13 mm using a biobloc or a DNA/ALF appliance so the patient can breathe? After all, Zinjanthropus did not suffer from OSA and SDB and slept like an angel. And who says lip incompetence, mentalis strain and drooling due to extreme bimaxillary dentoalveolar protrusion is bad? I think we should focus our CRAP therapy in increasing overjet, protrusion and improving spinal and planetary alignment. If loss of 25% of teeth lead to functional decrements, then a gain of 50% of teeth should lead to awesome increases in performance. Research by Dr. Canard shows that opening space for extra teeth (preferably a third premolar per quadrant since the body reacts differently to those) shows a corresponding increase in brain function…just like Neanderthals. Just think about this for a second – 100% of people who have premolars extracted will die. Time to take a deep Buteyko breath.

  19. Dick Beugeling says:

    Great. Can I charge my iPhone with the electromagnetic waves , too?

  20. Lysle Johnston says:

    It is as if you had asked all those who believe in some sort of parallel-universe, theoretically unlikely science to identify themselves by sending an indignant comment.

  21. Geoffrey Wexler says:

    Would 60 Minutes publish this? They’ll be able to dumb it down for average joe blo to understand better. Perhaps – but perhaps not.

    The problem for me in this sequel, is that the rebel forces were painted as forces of evil. This runs against the grain, because, as we all know, rebels are good, common folk who just want live in peace, who are only motivated to overcome egregious, evil self-serving, corrupted establishment powers. So, unfortunately the story doesnt quite fit the mold. Perhaps it may sell better if Rebels can be be recast in a different light (that is very uncharacteristic for a rebel, and another description would be needed, perhaps Narco is apt. This would be a Rebel that is an opportunistic, predatory, greedy, purposefully uneducated, scruple-free, lying thief. The cynical amongst us may simply view this as just the business world at work, and let the market decide. The casualties on the way are unavoidable collateral damage.

    • Geoffrey Wexler says:

      Of course the normal comumity regulators are powerless to stop such terrible forces ov evil, so we are going to need to rely on Superman and Spiderman to save us. But the good angels are going to save us.

  22. Good to know you also have a sense of humor, Kevin 🙂
    The downside is that if this really is a stab at the “biobloc or a DNA/ALF appliance” folks who increase the “overjet to 13 mm”, then I am disappointed. As a professor, it was my job to invoke new thinking in my residents and students. (I don’t how successful I was in that regard, except that one was awarded first prize at the AAO for an ‘alternative treatment’ and one was awarded a prize at an IADR meeting for airway research, et alia). But, the point is that if you have a hidden agenda, then the danger is that you might stifle innovation in the next generations who will be intimidated to challenge the status quo. Put simply, are you saying that all ‘traditional’ orthodontic treatments are successful all the time? And are you implying that all other treatments are not successful at all? In that case no further ‘orthodontic’ research is required. Strong words spoken in jest can’t disguise the underhand approach, my friend 🙂

    • Kevin O'Brien says:

      Hi Dave and thanks for the comments. No, please do not think that this blog post was targeted at particular developments. My main target was all developments that are introduced and promoted without any good scientific evidence.
      As regards your second point, it is clear that all methods are not successful all the time and we need research to help us improve the effectiveness of our treatment. But, we all need to engage with research and not just make statements about developments in the absence of evidence. I hope that this has answered your questions.

  23. Nice post. It seems that the ability to gain insight from satire is closely linked to evidence based thought processes…….It would be funny if it wasn’t ruining my profession…..
    You demonstrated but did not mention one other important step to promoting your treatment: Generous use of words and phrases that sound like they have a specific, accepted definitions but actually have no real meaning in treatment or within the profession. Words like “traditionalist” , “soft tissue dysfunction”, or “thoughtful treatment” are a couple that I have heard recently.
    And, one more point if I may,
    How can anyone with a shred of intelligence believe that the earth orbits around the sun? Anyone with eyeballs in their head can clearly see the sun moving across the sky circling the earth every day! I don’t need some some pointy head, ivory tower, dry fingered non clinician to quote some meta analysis of data to tell me what what to think!

  24. Jayaram Mailankody says:

    Hasn’t this been the ‘modus operandi’ of Orthodontic ‘philosophies’, analyses(model & ceph), appliances and marketing, all these years, for more than a century ?

    • Kevin O'Brien says:

      I am not sure this has been the case and when we consider developments in the past, these were promoted with the best knowledge and some research at the time. What we are facing now is many developments being introduced and promoted with a complete absence of evidence and people know this.

  25. Marcel says:

    Hi Kevin:

    I thoroughly enjoyed this post! But keep in mind that good innovations need to follow a similar path.

    I have been following your posts for quite some time now. I am not an Orthodontist – but I do work in Orthodontics since a few years now and am learning a lot form your posts! I am on the “business development” side of Orthodontistry and I do appreciate people critically looking at new developments and calling out “bullshit”.

    At the same time I am sometimes surprised by how critical the industry is towards new developments. In this industry sometimes good inventions can take years to get hold, or don’t make it because of “traditional” thinking.

    For example Invisalign is a great product that can be used for a wide variety of corrections, and yet in the first years most orthodontists were sceptical and claimed it does not work. Still today many Orthodontists reject Invisalign. It is the best product for Adult treatment – and NO, I don’t work for Invisalign. I actually am getting my teeth corrected with it and I would not accept any other treatment.

    Two messages I would like to share form my side:

    1.) It is good to look at things critically, but one should give new developments a chance to prove themselves. If in doubt watch it or try it. Shoot things down only if there is clear evidence that it does not work. We do need those people who are willing to try new things to advance an industry. Those products that don’t work will fizzle out by themselves.
    2.) Listen to the consumer. Ask your patient what he or she wants. That is always the starting point for any treatment.

    Best regards, and please keep up the good work in looking at things critically.

    p.s. I sleep very well at night, as I am a 100% believer in our product., and I could not sell a product I don’t believe i.

    • Arthur Cooper says:

      Hi Marcel,
      My cupboard is full of devices that the manufacturers claim to be revolutionary and fully researched but are totally useless. They even come back to market every 20 – 25 years to sucker a new generation of dentists. My favourite is the needleless, painless injection. When you complain to the manufacturer you are told that you are not using it properly , so no refund. The third incarnation of my practising life is now being marketed. The early TP ceramic brackets separated from their plastic bases and the “new improved version” was no better. Patients are not guinea pigs.

  26. Fenris Ulfr says:

    As Airway-Friendly Orthotropists one must ask why academia is mired in ludicrous systematic reviews, RCTs and meta-analyses?

    The question is not if a technique or product works, but more importantly, Can you prove that it does not?

    For example: Epigenetics can prevent migraines, male hyperemesis gravidarum and helminthiasis, and releasing restricted lingual frena can prevent spina bifida.

    Where is the clear evidence that it does not do all of the above?

    Our allegiance MUST be to our products – regardless of if they work or not, and ESPECIALLY if they don’t work.

    Have you ever had a patient whose previously normally inclined incisors are now parallel to the floor after Biobloc or Orthotropic Pneumopedics?

    The tears in their eyes, their now unfettered tongue and their endearing lisp make it all worth it , Evidence or Not! If that doesn’t make you a 100% believer, what will?

    It is time to listen to our patients, who after all are the scientific experts (not us) and ask them if they’d prefer a DNA, ALF or another abbreviation.

  27. Dan Turesson says:

    Hi, great post!
    Anwer: It will work! You will be very rich but with a bad sleep!

  28. Larry Tadlock says:

    Kevin,

    It doesn’t surprise me that some are stung by the inference that snake oil doesn’t work. I suggest that you add to your bio that you are also a “progressive thinker”, as well as the free thinking maverick you describe. That should get a few more responses.
    Also, I suggest you reduce the size of the pack and add a warming pouch. This should speed the development process for faster treatment.

  29. If I attend your course will I be awarded an MSc that is registerable with the gdc? Can I then call myself a specialist orthodontist?

  30. Kamaldeep Sharma says:

    Sir this is one amazing blog have read from your side in which without naming any one particular in person or in treatment modality, you have passed your msg so beautifully.
    I am a grt admirer of your blogs and follow them without commenting but this one needs special commendation. Hats off to you sir to expose how appliances and modalities are being marketed, for that matter even individual orthodontist market them, by telling them they are different and doing different things. There favourite phrase will be ” I don’t know about you but it works for me.”

  31. Hilarious! I love your sense of humor.

  32. Mike Mew says:

    Kevin,

    I do hope that the laughter has died down. Your post leaves the impression that you are taking a direct swipe at orthotropics!? And possibly other associated concepts. It is there all but in name and you seem to be suggesting that we are running some sort of scam? In all, it comes across a little unfair.

    You do make some quite strong statements, in what is realistically slander by any other name. Are you really calling me (or my father) a snake oil salesman? I’m not here to retaliate, I’m here to do science, whilst wanting to maintain cordial relationships.

    First. Do you think that you could respond to my mail of the 8th March and if possible give me a constructive review of the 16 consecutive case pilot that I undertook at your request? I have been almost pleading with you to help me to gain ethics approval to start a cohort, having detailed the journey to start some research in which writing to every orthodontic department in the country at least twice. What else can I do and who else will help me?

    Second. You might not have heard but I was actually very interested in debating some issues, and since you seem to be inviting an offer of debate then I will accept, possibly on the aetiology of malocclusion! Could you get back to me with details?

    Third. You are calling me out, and I’m accepting this too. I’d really love to participate in a scientific review on orthotropics, it would be an excellent opportunity to get those references nailed down, and check they stand up to contemporary scrutiny, don’t you think? Might we do a series of opinion pieces in the BDJ, we each critique the others therapy and then defend the critique. One-page max.

    In reality it was an excellent article, sometimes humour is the best way to breach a subject. It certainly seems to have worked. Either I have a very strong point or I am wholly wrong and need to be enlightened, urgently as it seems. I just want the truth, the whole truth and no dogma.

    Awaiting your response,

    Kindest regards,

    Mike

    • Kevin O'Brien says:

      Mike, thanks for the comments. I will address your points.

      1. This post was not aimed at any particular orthodontic intervention. I am not sure why you feel that it was aimed at orthotropics. I certainly did not mention this type of treatment. My post was a light hearted look at anyones who promote “new” treatment that lacks evidence and could apply to types of brackets, self ligation philosophy or indeed other forms of dental care.
      I would like to state that I am not calling you or your father snake oil salesmen.

      2. You mention the sample of cases that you sent to me. I have looked at them, however, as I explained to you in an email, I cannot do much more to help, as it is difficult if not impossible to work with you while your Father is reporting me to the General Dental Council. This approach does not encourage collaboration.

      3. I am not offering to debate with you, I was offering to help you with some research into orthotropics.

      4. I am also not calling you out. I am not sure why you feel that this is the case. Like you, I would like to investigate orthotropics further, and this is the only way to make progress. Having a debate or doing a literature review is not a good way to go forwards, we need to analyse the results of some treatment. But this is on hold, until I know whether I am being reported to the GDC or not.

      Best wishes: Kevin

  33. This is totally preventable and is all in the hands of how you care for your teeth with the braces on. Who wants to work so hard for straight teeth to end up with white spots?

  34. Mike Mew says:

    Dear Kevin,

    You must excuse my clear narcissistic tendency.

    As you say “orthohydrotonics” is not orthotropics, this new disease of “craniofacial-osteodental dysplasticum” is not Craniofacial Dystrophy (any other new diseases, or suggested pathologies out there Ed?), the “North England School of Cranial Release Aquatherapy Provision” is not the London School of Facial Orthotropics and it must just be a coincidence that my father also calls himself a maverick and free thinker. Very sorry to have jumped to any conclusions, please excuse me.

    And of course in reality it is the BOS and orthodontic establishment in the UK who are avoiding debate and enquiry, in particular the one on the aetiology of malocclusion, that I eluded to.

    While I acknowledge that you are not referring to orthotropics, it would be a good opportunity to remind you that we zealously wish to lay ourselves (and our supporting references) bare to contemporary scrutiny, respond to scientific challenges, engage in debate, and start whatever research possible. All we ask for is a level independent playing field.

    As you rightly note there’s a vacuum of quality evidence in orthodontics, and, this has been filled by a range of ideas, some ludicrous and more reasonable. Should we not apply the above test to all these ideas, including any incumbents.

    Regarding the research. Are you sure that you have looked at the pilot that I did for you, I might have missed it but never saw the drobox file shared by you or Martyn, and if so please do get back to me which your thoughts on this, as you agreed? I do feel left in a difficult position with people (not you clearly) saying that I’m not doing research while I cannot, as every single door is closed in my face. Also as I’ve mentioned, I believe that it is only in North Korea that people are held responsible for the actions of their parents (who is no more than a part time associate at my clinic), and if you are unable to help could you refer me to someone else who could?

    Finally, I will take this opportunity to formally challenge you to a debate on the aetiology of malocclusion, as I am sure that this will help shed light onto this vacuum. As this is a much needed area of further investigation and we could keep it as light hearted at this article.

    Best wishes,

    Mike

    • Kevin O'Brien says:

      Thanks Mike, your perception of the blog post is entirely up to you, but as I said it was not aimed at orthotropics.

      As I have said to you many times, I am not interested in a debate, as this will not lead to anything and will be a waste of our time. But I am interested in research and I would happily devote a large amount of time to this. But I cannot work with people who work closely together in the School of orthotropics, when one of the two staff are threatening to report me to the GDC. This does not bode well for co-operation. I have looked at the cases that you sent me and I was going to reply to you with my opinion in detail, but the GDC issue has prevented me.

  35. Lysle Johnston says:

    You stand astride a widening rift between science and commerce. I have been threatened with lawsuits for 30 years. I suspect that you soon may be joining me. As noted in an earlier reply, I suggest that the first step in assessing new treatments is to decide whether there is a compelling theoretical basis. Failing that, the game is usually over. If it quacks like a duck and waddles like a duck, I will assume provisionally that it’s a duck. “Debates” about claims that, at the outset, seem unlikely are of little interest to me. We–you and I–have better thing to do than play “whack-a-mole” with the treatments that proliferate in today’s orthodontic marketplace; the generation of proof isn’t our obligation. As for me, I have enough trouble with my own ideas…and my elderly British autos.

  36. Mark Luden says:

    Lysle,
    Very good point. But, perhaps we could assess traditional treatments with the same rigour as ” new” ones? Traditional treatments are just that, traditional. They may not have a compelling theoretical basis either. We accept what we have been taught, if only, perhaps to avoid the ire of a self-assured department chairman whom we do not wish to antagonise. But, if we are honest with ourselves, not everything that we have been taught was true, whether we are referring to Astronomy, Physics or Orthodontics. It is long past time to admit that some traditional concepts are wrong, and some new ways may, in fact, be correct

  37. Do believe you’re spot on! I had to develop my own relief! As a patient, this article terrifies me… As a vendor and professional, I also loved this article, and believe all students of dentistry of any sort, should have to read it…

  38. Mike Mew says:

    Kevin,

    Thank you for your response, and for publishing my responses. To wrap this up,

    1) Given the circumstances I would greatly appreciate any help that I can to start a simple prospective cohort. It is easier to be critical of people not having research data than to help them achieve this, and it seems that no one wishes to help.
    2) With due respect I think that you are mistaken in your belief that a debate is unnecessary and be a waste of our time. This is a healthy part of science and given the circumstances it is really needed. The balance of good quality evidence suggests a strong environmental aetiology, but seems ignored in most therapies provided. Medicine is about treating the causes of a problem, and asking for more research before the full value from existing research has been exhausted seems unethical.

    I am in gratitude for your bringing this topic up. Even if this was not direct this at orthotropics I know that many orthodontists believe that the implied criticism (coincidently) fits orthotropics perfectly, usually with little knowledge of the subject. It doing this you have given me a forum to counter this argument, express our point of view and feasibly influence some people’s opinions.

    Mark Luden makes a good point, and Orthodontics needs a critical review with fresh eyes and what better place to start than the cause?

    Best wishes,

    Mike
    Further discussion at; https://www.facebook.com/groups/Orthodont/permalink/1276276112391316/

    • Kevin O'Brien says:

      Hi Mike, thanks for the reply. I will deal with your points.
      1. No problem, I have offered to help you with the cohort study and indeed you sent me a series of cases for me to look at to make sure that I was comfortable with the ethics of the cohort study etc. But then your Father threatened to report me to the GDC and despite many attempts by me to clarify if he was really going to take this step, 6 months down the line I am no closer to knowing what he intends to do.

      2. I am 100% convinced that a debate is not necessary, it will simply be a waste of time. You are correct that we not fully understand the aetiology of malocclusion, but you have a theory and if it is correct then the results of your treatment will help us move forwards. So lets see the results of orthotropic treatment. I know that you have problems getting your case reports into the journals. But if you send me 10 cases with full records including cephalograms fully consented for internet publication, I will publish this paper on my blog. It will be read by more people than any journal.

      3. You still seem to think that the “snake oil” post was directed at orthotropics. I will emphasise again that this is not the case. I fully appreciate that orthotropics is important to you, but in the whole scheme of orthodontics it is not practiced by many people and my post was directed at other “treatments, therapies and philosophies”.

  39. David Briss says:

    Thanks for your post Kevin, I really appreciate your satirical take! Like all good satire there is a basic truth, and I probably don’t have to tell you that yours is rooted in the well-known logical fallacy of argumentum ad ignorantiam (something is true unless proven otherwise), or the other well-known construct, “absence of evidence is not evidence of absence”.
    The burden of proof in argument is always on the person making the assertion, it is never the responsibility of the respondent to reject the claim as negative. Per Adler, knowledge of the negative cannot be established by direct observation. I believe that proper philosophical argumentation is always necessary, even to the notion that it is incorporated into the idea of the null hypothesis, which every one of us in engaged in scientific pursuit should understand.

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