Article
The concept of the six month smile using orthodontic means first came to my attention a few years back when this, to me, seemed a great deal faster than the orthodontics that I once learnt. In the past year, the subject has been driven back into my thinking by the seemingly relentless rise in advertising for (almost) instant orthodontics, in which treatment is completed in six months or less. This seemed to be particularly acute at a dental meeting a few months back, when I counted more than thirteen stands offering training of varying duration, but often for two days or less. Most recently, I attended a lecture on the subject of (almost) instant orthodontics, with treatment being carried out in periods of six to sixteen weeks: it was bereft of references, and scientific information regarding the long-term stability of the treatment was absent. There was a mention of a positive audit of over 1500 cases carried out by the speaker, but no other details were provided. The only plus point that I could ascertain was that it appeared that teeth would be cut less in order to achieve a good cosmetic result. Most worrying to me was the statement that ‘the teeth were quite mobile at the end of treatment’.
The topic has been given a substantial airing in another UK-based journal in the past six months, with the protagonists Drs Maini and Chate again slogging it out in a recent issue1,2 on the subjects of ‘jiggling forces’ and the interpretation of the literature. It all seems to be down to expert opinion/anecdote versus scientific rigour and the attraction of a fast earner – the lecturer who I listened to mentioned profitability of £750 to £1,000 per hour! Who, indeed, can fail to be attracted by this? It is left to Dental Update to publish, in the present issue, a well-balanced report, by Drs Aulakh and Banerji, on short-term ‘cosmetic orthodontics’, in which the need for accurate diagnosis, not placing teeth in a position of instability and good treatment planning are stressed, with the authors adding that a retention protocol as vigilant as for comprehensive orthodontic treatment was needed. This surely is the way ahead.
Finally, I mentioned the concept of ‘Instant Orthodontics’ in an editorial some years ago, when I was concerned by the cutting of teeth in order to achieve perfect alignment. The orthodontics which I now write about seems to be designed to prevent the gross destruction of teeth, which was once taken as the norm, and is therefore to be commended if carried out within scientific guidelines and with a strong evidence base. However, it is worth mentioning that there has been a recent large increase in cases against general dentists involving fast orthodontics, particularly those involving aligners (Personal Communication, KJ Lewis, Dental Director, Dental Protection Ltd, London). It is also worth mentioning some appropriate sections of the recently published UK General Dental Council document,3 which is mentioned in the ‘Letters to the Editor’ section in this issue. It contains the following statements:
Is two days' training therefore appropriate? It would seem that an increasing number of patients do not think so.