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Orthodontics: From a Whole New Angle

Dr. Craig Feldman

Malocclusion, it’s really just a ten-dollar word for a “bad bite.” Or, as Edward Angle ("the father of modern orthodontics") defined it: “a misalignment or incorrect relation between the teeth of the two dental arches when they approach each other as jaws close” Well, while that definition still holds true, there’s a whole lot of other things about “modern orthodontics” that have changed since Angle’s death in 1930.


Dynamic diagnostics
Let’s start with diagnosing a malocclusion, which is and has always been the key to successful orthodontics. Modern technology has allowed diagnosis to develop even further than Dr. Angle could have ever imagined. No longer is it necessary to use photographs, plaster models, and simple radiographs to diagnose a case. Today, your orthodontist has computer diagnostic models and 3-D radiographic images of the skull and soft tissue -- right at their fingertips -- to use in determining the best approach to treatment. The emphasis of the soft tissue as it relates to function and the appearance of a smile is of particular interest. And thanks to Snapchat, lnstagram, and Facebook, a smile’s aesthetic is now more transparent and important than ever.


In a material world
Materials have dramatically changed the world of orthodontics. Gone are the days of fitting large bands around all the teeth. (Remember those “train track mouths”?) Instead, we are able to bond small brackets directly to the teeth. And the bracket materials themselves have improved to include titanium and ceramics for greater efficiency and a better appearance. Additionally, brackets with a lower profile, along with more subtle, transparent wires, have not just improved appearance, but also dramatically increased the speed and rate of tooth correction, so a patient can have the braces removed even sooner.


Stick to the science
Of course, while all of these advancements are very promising, I have always practiced orthodontics using a scientifically based approach. In essence, if something sounds too good to be true, it probably is. In other words, if someone promises to turn your complex alignment issues into straight teeth in just six months, you should probably start asking some hard questions. This is especially true when orthodontia is suggested for young children. That’s when you need to ask what the real benefit (to you or your child) is of early treatment. And if that orthodontist cannot answer this question in a clear and convincing way, then that is reason alone to seek a second opinion.


When all is in perfect alignment
Finally, a discussion needs to be raised regarding thermo-plastic aligners on the market (such as lnvisalign®, Clear Correct, Smile Direct and others). There is no doubt that the advancements in this field allow this type of treatment to address the issues in a reasonably efficient manner, and in a dramatically shorter period than traditional orthodontia. In fact, for some patients, this approach is ideal, especially for adults who have had orthodontia before, and for some teens. However, the main advice I would offer is that complex cases, and those of most children and teens, be treated by a trained orthodontist. That’s because, more often than not, a general dentist won’t have enough experience treating difficult orthodontic cases, and might have difficulty treating these cases should problems arise.

So, while new technology has allowed us to come a long way from long-lasting, uncomfortable, unattractive “metal mouths,” I think there is one thing that has not changed much since Dr. Angle’s day. And that is, we are always searching for newer, better, and safer ways to offer our patients the smile they are looking for.

 
 
 


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