August 14, 2017

An A-Z of orthodontics.

An A-Z of orthodontics.

As we enter the dog days of a long wet English summer, I have decided to write a simple A-Z of orthodontics.  It is meant to be light hearted….


Accelerated Orthodontics: A new orthodontic development that is currently not supported by scientific evidence. Promoted by Key Opinion Leaders. Maybe Snake Oil….

Bracket: A component of an orthodontic appliance that is stuck to the teeth.  There are several types and range from conventional to others which are magic (see self-ligating).

Conference: A meeting of orthodontists that is organised by an orthodontic society. The conference has  a scientific programme. This includes lectures, some of which are well attended (clinical show and tell), others (research) are not.  There is a trade exhibition with other lectures by Key Opinion Leaders (see later).

Damon Bracket:  Self ligating bracket. Advertising claims have been recently criticised by the UK Advertising Standards Authority.

Edgewise Bracket: Conventional bracket that seems to move teeth well. This is dependent on the skill of the operator.

Fastbraces: Are they?

Growth of the face:  Used to be influenced by orthodontic treatment. Now it is not….

Headgear:  Old orthodontic technique directed at modifying growth and reinforcing anchorage. It does not modify growth. Superseded by temporary anchorage devices.

Internet:  Sole source of clinical information for some orthodontists

Journal:  Traditional method of disseminating information.  Articles are mostly behind paywalls and not accessible (apart from in the Angle Orthodontist). In general, the journals need to modernise and become more accessible.  A good alternative source of information to Facebook.

Key Opinion Leader: Clinician who is paid by an orthodontic company to promote their products. Has a tendency to ignore scientific information.

Ligature: Old effective way of tying a wire into a bracket.  Seems to work well..

Myofunctional appliances:  A treatment that has amazing effects on breathing, facial growth, position of the teeth and academic performance.  Unfortunately, it is not possible to measure the effects of this treatment.  Possibly Snake Oil.

Need for orthodontic treatment: A vague and constantly changing concept. A major problem for funded orthodontic treatment.

Orthodontics: A great speciality and treatment that benefits many people.

Professor doing a blog:  A person who is trying to disseminate knowledge. Maybe a “stuck record”..

Quack and snake oil salesmen:  We know who you are, do you? But where do we draw the line? For example, one person’s speeding up treatment maybe another’s quackery?


Retention and relapse:  The greatest orthodontic problem and mystery…

Sleep disordered breathing: A disease that may, or may not, be influenced by orthodontic treatment.  Has potential to be quackery?

Self ligating bracket:  I decided to use S twice. I have said enough about this subject. Claims are likely to be Snake oil.

Trade: Our close working colleagues who provide us with equipment. Their role is to sell. We have to interpret their claims using our scientific knowledge.

Undergraduate Dental Student:  A person who is learning to be a dentist and is exposed to minimal orthodontic training in most countries, because of a shortage of academic orthodontic staff.

Volume of airway:  I do not know if it is changed by orthodontic treatment. Does anyone?

Websites: Valuable source of information about orthodontic treatment. Some also contain a large amount of misleading information.

eXtractions: Method of making space for orthodontic tooth movement. Does not cause harm if correct mechanics are used.

eXpansion: Method of making space for orthodontic tooth movement. Does not cause harm if correct mechanics are used.

Young person: Orthodontic patient who we do our best to help.

Z Spring: Simple way of correcting a cross bite.

If you want to add to the list or make comments, can you post them in the comments section?

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Have your say!

  1. Z-springs and Z plasty for clefts 🙂

  2. Z-string method of retracting stubborn canine teeth 🙂

  3. Z-spring: Still works to correct anterior crossbites in mixed dentition?

  4. Z angle! Interesting post Professor! Always enjoying Your blog. Thank You for sharing and spreading Your knowledge and experience!

  5. E – Evidence Based Medicine includes Dentistry and is based upon combination of 3 factors equally, not just 1 dimensional and often poor quality published literature in Orthodontics.

    T- traditional orthodontics, claims to be evidence-based but it turns out many of IT’S claims and teaching, are misleading, according to ASA criteria of Multi-centred RCTs now needed to make ANY clinical claims publicly!

    Z- Zapped, a new term that removes past mysticism and recognises Orthodontics is just Dentistry and most routine cases are best done by general dentists, with Soecialists seeing gge more complex ones, like any other arena in Dentistry perhaps?

    I have other letters but that will do for now 😉

    Yours also alphabetically,


  6. Please explain to me why headgear does not modify growth

  7. Begg technique: sliding mechanic by using vertical slot

  8. Dear Kevin, You made it!
    This post is your very best ever.
    I can imagine the list growing fast and the way That it can teach directly tô the point.

  9. C&C
    Chalk & Cheese
    The difference between which has been obliterated by orthodontic supermen.

  10. This is an excellent overview of the lack of solid ‘anything’ in the profession…may save a person thousands on expert witnesses. Looking forward to evidenced-based treatment options!

  11. Functional Appliance: Fixed or removable device claimed to correct Class II malocclusions by growing mandibles (see snake oil)

    • Clearly you haven’t read the actually available literature on functional appliances. There is no claim at all that functional appliances grow mandibles, but there is a plethora of literature, both university based and otherwise that elaborates on the changes to the Temporal fossa, including the mechanisms driving these changes, which can be significant, and also the condylar changes, which are very minimal, but still do happen.

  12. Why do people claim that headgear does not modify growth?

    • This relates to some of the classic studies , Tulloch et al in an RCT follow up in 2004 showed the orthopaedic affects of headgear were lost with growth. I’m sure theres more out there but this one rings a bell as it was over a 10 year follow up period.

  13. Protraction Face Mask: short term or permanent skeletal effect?

  14. Great post Prof

    P: Post CCST – junior and senior member of staff simultaneously, experiencing the worse bits of both

    My details to remain anonymous, understandably I think

  15. Kevin:Good Post. Your talent for mixing humour and sarcasm, to the facts and beliefs is commendable-so also your committment to ‘strong evidence’. It was a good read indeed.

  16. P- Pyramid of Denial. A surprisingly ubiquitous concoction of sophistry and illogic. Frequently seen amongst members of the Flat Earth Society and other purveyors of serpentine unguents. Said proponents can be recognized by their mephistophelian aversion to evidence-based medicine & published literature making frequent claims that orthodontics is just dentistry….

  17. orthodontic education & training: a way experts & institutions earning alot of money from poor dentists

  18. cognitive dissonance:
    what you have been sanctuary taught and rigorously implement in conflict to an evidence informed attitude.

  19. I loved this accurate versions of every word wish i could start following your blogs a little earlier. But it’s ok we can never be too late.

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