Orthotown May 2018 - 8

embrace progress

Will the Pendulum Stop Swinging?
Orthodontics must strike a balance in a paradoxical
profession of emerging trends and old habits
by Dan Grob, DDS, MS, editorial director, Orthotown magazine

Adopting a new vision
It has been said before that if you're in
this profession long enough, you'll witness
major changes in thought. Sometimes those
changes are based on science, sometimes on
experience and sometimes on economics.
We've seen orthodontics become a profession
with non-extraction, then extraction of
permanent teeth, and then, most recently,
a more moderate methodology.
We've seen the rapid rise in surgical
orthodontics, only to be replaced by cautious
and less invasive approaches. Self-ligating
appliances were to revolutionize the profession and eliminate the need for expansion
and tooth removal. TADS are popular, but
with an invasive approach and a definite
failure rate, they have not taken over the
need for conventional orthodontics.
Relatedly, various cephalometric analyses
exist to diagnose and at times justify our
moods and mechanics.
As I sit in a comfy chair at Chicago
Midway Airport (one of only a few remaining
chairs on an early Sunday morning), I feel
compelled to share my experience this
weekend at a meeting sponsored by (of course)
some equipment and supply companies with
vested interests but presented by doctors
committed to bringing a vision of practice
we all dream of. A vision that changes the
lives of children forever is not concerned
with how many aligners are needed or how
quickly treatment can be completed. No,

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MAY 2018 // orthotown.com

this vision is focused on the lives of growing
young people so they have a chance to reach
their true facial and medical potential. I'm
speaking about CBCT and the impact it
will have in our profession as it gradually
becomes a part of every orthodontic practice.
While at the meeting, I sat with some
experienced orthodontists who all agreed
that 3-D was something thrust upon us.
After all, how much justification is there for
checking on the position of impacted canine
teeth with a six-figure X-ray machine? My
favorite oral surgeon always said that when
in doubt, go to the palatal side, because the
odds were that that's where the tooth was.
At one point, TMJ health was a topic that,
in our minds at least, justified an occlusion
scheme and correction with orthodontics.
Periodontal health is certainly improved,
at least in the lower anterior segment with
judicious orthodontics. Airway health is, I
believe, the new justification and guiding
force for treatment of malocclusion, and it is
beginning to appear that airway volumes and
measurements are improved with orthodontics.

Growing importance of Phase I
We have been aware of the improvement
of nasal volume with rapid palatal expansion
for years. Better airway health benefits
patients with better breathing, alertness
and energy. Breathing through the nose is
important to filter and moisten the air, as well
as to help reduce poor tongue posture and
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Table of Contents for the Digital Edition of Orthotown May 2018
