What do I know about orthodontics?
I am going to retire from the University of Manchester at the end of September and spend more time on this blog. As a result, I have been reviewing my old lectures and thinking about putting them online. This has made me think about orthodontics over the past 40 years. I have been working as an orthodontist and researcher since 1986. But what do I know about orthodontics? This is a simple list of my academic/clinical knowledge and opinion which I have updated with information from the past years blog posts.
You may not agree with me or call me “old fashioned”, but here we go…
- Malocclusion is caused by a combination of genetic and environmental factors. We cannot be sure of their relative contributions.
- There are many ways to treat malocclusion and most of these treatments work
- Evidence-based orthodontics is a combination of clinical experience, patient opinion and scientific research. The relative influence of these factors varies according to our level of scientific evidence.
- Arch form and dimensions should generally be accepted
- Functional appliances and other bits of plastic, pistons and springs do not change or influence facial growth. They simply tip teeth, and they do this very well to treat complex malocclusions.
- To my knowledge, there is no high-quality scientific proof that orthodontic treatment, extractions, appliances, expansion, myofunctional orthodontics influence breathing, posture, academic attainment, facial growth and sleep-disordered breathing.
- The Carriere appliance has no scientific evidence to underpin the claims that are made on skeletal correction, treatment times and influence on the airway.
- Class I molar non-extraction treatment is very straightforward.
- I wish that I knew how to intercept malocclusion…
- Extraction of permanent teeth is required for the treatment of some malocclusions..but treatment mechanics are as important as the extraction decision.
- Anyone can treat their patients non-extraction. But not all patients should be treated non-extraction.
- Temporary Anchorage devices are better than other anchorage reinforcement method by about 2mm
- Wire and bracket properties do not influence the efficiency of alignment
- None of the new developments that are supposed to speed up orthodontic treatment seems to work.
- There is no evidence that Invisalign mandibular advancement appliances, advance the mandible.
- Self Ligating brackets do not have any advantages over conventional brackets.
- There is excellent high-quality research being done in orthodontics, and our evidence base is strong.
- Some Key Opinion Leaders need to consider whether they are ethical when they make claims about the appliances that they try to sell. They are becoming a threat to the integrity of our specialty
- Being an orthodontist and treating patients is a great career. We provide excellent treatment to many people and change their lives. We must not forget this. I have really enjoyed myself.
- Writing an orthodontic blog is a great thing to do in retirement.
That’s about it, does anyone want to add to the list?
Emeritus Professor of Orthodontics, University of Manchester, UK.