There are many orthodontic myths just as there are dental myths. Probably the most common orthodontic myth is that malocclusion is largely a genetically determined thing. There are books I’ll cover in another blog for readers interested in learning about how the environment is a much more plausible cause of malocclusion. I think an orthodontic truth should be established that malocclusion is largely environmental.
Perhaps one of the most common dental myths is that wisdom teeth, also known as third molars, cause lower anterior teeth to crowd when they erupt. I’m unaware of even one article in the refereed literature which would support this contention even though many lay people on the street would agree that this is an “orthodontic truth”.
Very few people seem interested in seeing myths debunked, and I’m suspecting this is why articles have not been written to do that.
Airway health is now a very important topic but there are still many airway misconceptions. One of the misconceptions that I hear too frequently in the profession is that the orthodontic profession cannot cause airway problems and nor can they do anything to treat airway problems. I’ve re-opened previous orthodontic extraction sites and have seen OSA (Obstructive Sleep Apnea) resolved as shown with a polysomnogram (sleep test) signed by a board certified sleep physician. I also have treated a 5 year old boy for his sleep apnea with his sleep physician confirming with a sleep test that the problem was eliminated. It is interesting to note that orthodontists were treating children in the primary dentition to essentially prevent “mental retardation” more than 100 years ago. For those interested please look up articles from Dr. Bogue. I look forward to the day when airway health facts would include information about this very issue.
In my practice people sought treatment to improve airway health for their kids all the time. I’ve never once promised one patient that anything we might do would increase their airway. I do believe that there are a number of things which can do this and the public would benefit from being given a list of airway health facts.
If one were truly wanting to have orthodontics explained, they might want to know what is scientific and evidence-based in the profession. Several years ago the German government did an exhaustive literature review to see if there are long term health benefits to traditional orthodontic care. I read that the government was unsuccessful in finding any long term health benefits documented in the literature. They stopped funding orthodontic care.
There is growing concern in the profession regarding the inadequacy of polysomnography (traditional sleep test) and many people are discussing how home sleep tests can be an alternative in some cases. Having said that, there are many in the industry who question the entire efficacy of sleep tests. I believe tools which may become more useful in the future will include autonomic testing which specifically focuses on heart-rate variability and DISE (drug induced sleep endoscopy).
I’ve said for years that we are truly in our infancy understanding sleep disordered breathing, quantifying it, and having easy to do and highly successful, predictable treatments.
I believe we live in a very dangerous age when false information is everywhere. Just as dangerous as that information might be, I firmly believe that many who are concerned about false information wish to either silence anyone who disagrees with their position or have others pass laws to do that very thing. False information is a hot item in the popular press and orthodontics isn’t immune from it.
As the son of an engineering professor who was a skeptic about many things in life and sought scientific proof for pretty much anything important, I pretty much grew up as a skeptic. In my lectures I openly announce and encourage everyone to be a skeptic of what I say and what every other lecturer says. As many others have said in the past, “If it sounds too good to be true it probably is.” I invite you to be skeptical of everything I am writing that you are currently reading. I also invite you to do the same for everything you read. At the end of the day you have only yourself to trust that you’ve done all the proper research for yourself to draw your own conclusions.
Some airway issues actually can resolve without treatment, however, that doesn’t mean there may not be consequences. As an example, if a child has very large tonsils and/or adenoids they may shrink as the child gets older. But there are 2 problems! The first is that the child may have sleep apnea which causes irreversible brain damage. The second is that the child becomes a habitual mouth breather which changes the facial growth to down and back. This direction of growth tends to make the airway smaller which may contribute to sleep and breathing issues in the future.
To me these are 2 excellent reasons to treat airway issues as soon as they are recognized.
Misinformation can lead someone to seek treatment that won’t resolve a given problem. Misinformation can also cause someone to NOT undergo treatment which has a good chance of helping. I’ve seen too many examples of both in my career.
Be skeptical of everything. Educate yourself. Make your own decisions about your own health. One of my mentors, the late Avrom King, stated, “Everyone has a built-in crap detector. Trust yours when it goes off.” I’ve tried to heed this advice and advise everyone to do the same.