A New Year post on orthodontic hopes and dreams.

I hope you have all had a good holiday break, if you took one. As usual, for my first blog of the year, I will review last year’s blog activity and then outline some of my hopes and dreams for orthodontics and this blog for next year. 

Summary of last year. 

I published 52 blog posts over the year. These were the top five most popular posts, each read more than 5,000 times.

1. It’s nice to see some sense about breathing and orthodontics.
2. Should we worry about the cytotoxic effect of orthodontic retainers?
3. Should we worry about microplastics and clear aligners?
4. A new trial concludes that early Class II elastics reduce fixed appliance duration.
5. Do premolar extractions influence the airway?

You can see that they addressed some of the current controversial aspects of orthodontic treatment, and it is good to see that we have such interest in these issues. 

People read my blog 380,000 times. This is less than last year, when it was read 420,000 times. This is a little disappointing, and I want to attract more hits this year. I have given some thought to this reduction in blog activity. It is difficult to identify any clear reasons. However, these may be;

1. Natural variation in readership (remember we cannot do much about this).
2. My blog is attracting less interest as other sources develop.
3. The subjects I discuss are based on the literature currently published, and the quality of this literature may either be dropping or becoming less interesting.
4. My blog is nearing the end of its life, and we are starting to see a natural drop-off in readership. This is common with long-established blogs.
5. Perhaps I am losing my touch and need to step up my game!

I also wonder about the effect of AI and other blogs on my readership. I have experimented with some AI applications and found that simply entering the title of a publication into any AI software package and asking for a blog post in my style yields a good post. However, they report the facts as stated in the paper without any real critical assessment. I hope that my blog can fill this gap in our current technology. However, I am fully aware of concerns that AI is beginning to take over much of current scientific writing. 

The good and the bad

As regular readers of my blog will know, this was a challenging year for me because we lost a great friend and colleague, Dr Betsy Bennett. Many years ago she persuaded me to include patient values in my research. This changed my research focus.

It is a great credit to the readers of this blog that when Jan and I completed a 22-mile charity walk across the UK moors the blog readers donated just under £7,000 to Maggie’s Cancer Support Centres in the UK. I am very grateful for everyone’s effort, and I hope we can make a difference in cancer support. 

Next year’s hopes.

One of the issues this year has been a dearth of high-quality, large-scale, randomised controlled trials. Regular readers will know that I have reported on many trials, but these are relatively small pilot studies. This reflects the difficulty of carrying out larger-scale trials. However, these are essential in many areas of orthodontics, and I hope that people take steps to improve the quality of our research. I will continue to search the literature for these papers as the journals publish them.

Another area where we have been inundated is systematic reviews. Most of these rehash old questions that have already been answered in previous systematic reviews. Furthermore, many of these reviews are not carried out to a high standard and are not particularly helpful. It would be far better if researchers conducted trials to address the questions raised by these reviews.

Further research

This brings me to several controversial areas of orthodontic treatment that need further research. I will be posting about on them in more detail. These are:

• The effect of orthodontics on the treatment and cause of breathing disorders.
• The use of outcome measures that are more relevant to our patients – rather than cephalometric tables, which report small effect sizes. 
• We need more substantial evidence on the effectiveness of clear aligners.
• There is growing concern about the impact of microplastics on the environment. One source of this concern, of course, is clear aligners and retainers, and there is an urgent need for research in this area.

I will also continue to keep a close eye on the claims made by some unscrupulous key opinion leaders in our profession. Their activity has reduced this year, but I expect a further increase as they identify “new effects” for the treatments they are paid to promote.

I have also promised myself that I shall not be so influenced by orthodontic social media. Over the years, my blog content has been affected by this, as I have felt the need to address some of the claims being made on social media platforms. This has not been without risk, and I have been subject to a fair amount of abuse from various people. I’ve reached the stage in my life where I can do without this, so I will try to rise above the white noise and the hassle.

Finally, I hope that we can have another good year with my blog, and I still enjoy interpreting the literature to help people understand the increasingly complex research activity..

I am looking forward to another year of posting, and I hope you continue reading this blog.

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