Have We Forgotten the Purpose of Orthodontics?
Our profession has evolved through our efforts to improve the function of teeth and improve the appearance of our fellow man. Both are noble endeavors. Many of our early pioneers spent their lives in their work with but one thought in mind-to find a better way to serve their fellow man.
We seem to have forgotten why we are here-why we work in the beloved profession of orthodontics. I don't want to be unfair to my colleagues. There are many exceptions, many members in the academic world who do an excellent job. An example of this is the prospective studies that are being carried on in our schools. They are working diligently to uncover concepts which will enhance the practice of orthodontics. Also there have been some excellent clinical studies pertaining to orthopedic effect of removable appliances.
In 1973 while visiting a professor in a foreign country I observed that he had very little interest in the patients being treated in his clinic. Treatment was being left to the discretion of students. He was a profuse contributor to the literature. .
In reading some of our journals, the casual observer could easily mistake them for financial journals, since they are full of tables and computer generated graphics, with very few photos of teeth. There is a professor, head of an Orthodontic Department, who thinks we know nothing about cause and effect.
In recent years there appeared in an orthodontic journal a research article which purported to determine whether deep bite malocclusions are associated with high angle malocclusions. The sample was not truly high angle (less than 40° SN-MP) and was not truly deep bite (4 mm to 5 mm). After pages of tables and computer generated graphics the conclusion was general and evasive. Articles of this calibre should not take up journal space. I wonder what reviewer would recommend such an article for publication?
In recent years the majority of the original articles published has had up to six authors and some of these articles have little value. It seems many of them serve only to get names in print. Again I do not want to be unfair to those who are conscientious and strive diligently (long hours) to contribute to our profession.
In my opinion we have too many members who try to contribute something other than clinical concepts, concepts that only will help us render a better service to our fellow man.
When are we going to begin to discuss the specific characteristics of a well treated malocclusion? There are a number of study groups in the USA which pay very close attention to these characteristics, but they seldom find their way into our journals.
In a very real way the orthodontic problem largely boils down to whether we are able to produce the proper amount of vertical development of the face. If there is an excess of vertical development, can we inhibit it sufficiently? If there is a deficiency of vertical development, can we stimulate it sufficiently?
The forward development of the chin is so closely related to the vertical development of the face, as that it can hardly be separated. If we can properly adjust the vertical development, the anteroposterior development of the chin will usually (but not always) take care of itself. This is not to belittle the importance of the lateral development of the dental arches, and the anteroposterior relationship of the lower teeth to their base.
When we begin to seriously discuss the specific characteristics of a well treated malocclusion, we will then begin to make real progress.
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