Oh! The Things We Can Do With Teeth!

We are able to prep teeth, remove the pulps of teeth, replace missing teeth, scale teeth, remineralize teeth, remove teeth, repair teeth and some dentists involved in research are even able to grow teeth! But an ability that is lacking for most? The ability to move teeth.

One of the most frustrating things for many general dentists is that they have to develop a treatment plan based on the current position of the teeth. Since the vast majority of adult patients will not seriously consider traditional orthodontics, most dentists don't seriously consider discussing this option with their patients. Sure, dentists and hygienists will oftentimes mention traditional braces as a possibility, but the conversation quickly ends when the adult patient rolls their eyes at the mere thought of having a mouth full of metal for two years.

How do you deal with tooth position problems? Do you offer up a referral to the orthodontist and when the patient says no, you succumb to the idea that your treatment plan will need to be based on the existing position of the teeth and gingiva? Have you tried using aligners for your patients with crooked teeth, only to find that the level of control and predictability you have with aligners is very much lacking? This is the plight of many dentists around the world.

This is the situation we find ourselves in, because as long as dental schools have existed the focus has been on training dentists how to deal with dental disease. Mal-positioned teeth have not, for the most part, been considered disease. Furthermore, orthodontia has historically been a complicated field that involved precise wire bending, fitting and seating bands, and multiple years of treatment. Ortho started outside the realm of general dentistry and has predominantly remained there. My experience shows me that we are all keenly aware of the fact that even as orthodontics has become remarkably simpler with the invention of super-elastic wires and pre-programed brackets, orthodontists have aimed to keep general dentists out of the business of moving teeth.

When aligner systems like Invisalign® entered the market about twelve years ago, everything changed. GPs now had an easy way to learn and implement orthodontics in their practices. We were all thrilled. Adults now had an attractive alternative to traditional braces and we, as general dentists, can provide straight teeth to them. The promise that aligners provided almost seemed too good to be true. In many ways, that has proven to be accurate. The limitations of aligners have created many frustrations for patients, orthodontists and general dentists. The lab fees are high, there is little control over specific tooth movements and compliance can be a problem. Aligners offer very restricted practitioner control over achieving the tooth movement that is desired. Rotations and extrusions are particularly difficult. Aligners can work well for some types of cases, but have proven to not be the panacea that was hoped for.

We practice in an era where there is no clear line between health and beauty in dentistry. Patients desire teeth that look great and function comfortably. The ability to move teeth to a more ideal position greatly enhances a dentist's ability to help their patients with both cosmetic and functional issues. Short-Term Orthodontics is a relatively new field within dentistry that has exploded because dentists understand the opportunities associated with being able to predictably move teeth in a short period of time.

Short-Term Orthodontics involves the use of tooth-colored brackets and wires to gently straighten teeth in less than nine months. Systems such as The Six Month Smiles® Short-Term Ortho System allow general dentists to predictably and safely provide an attractive orthodontic option to the adult patients in their practices. The short treatment times (six month average) are achievable because treatment goals are more cosmetically focused and the brackets are uniquely designed for this purpose. Goals of treatment are very similar to most aligner cases. Crowding is corrected, deep bites are improved and spaces are closed but Angle Class is not usually changed.

As dentistry evolves, dentists who can provide tooth movement in a manner that patients will actually say yes to, have an advantage. I believe that within the next few decades, Short-Term Orthodontics will be a part of the vast majority of dental practices. It's a great service for patients, the demand is high and dentists can get started with minimal training and low costs. The growth in this field over the last serveral years speaks to a future in which dentists can include moving teeth on the growing list of things that they can do. It's exciting for everyone, especially our patients.

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