Orthodontics is a specialty of dentistry that deals with diagnosis and enhancement of deviating positions of teeth and jaws. Other dental specialties like conservative dentistry (fillings, root canal treatments) and periodontology (treatment oft he gums) are dedicated to the therapy of real diseases, with the imminent threat of toothloss in case of non-treatment. Instead such a concept of disease cannot readily be applied to orthodontic findings. Thus it is important to say that orthodontic treatment is much more enhamcement than therapy. Most orthodontic findings are neither diseases nor do they promote the development of diseases.
In most cases it is a necessary therapy to remove caries and fill the cavity, as without this measure toothloss will be the inevitable consequence. The correction of deviating positions of teeth and jaws hast o be characterized as elective treatment, as non-treatment in most cases will have no medical consequences. Orthodontists have made some efforts during the last two decades to establish medical foundations for orthodontic treatments. It seems probable that some extreme orthodontic findings such as the narrow upper jaw combined with lateral crossbite or the retrusion oft he lower jaw with large overjet have certain medical aspects. Likewise, frontal crossbites and extreme deep bites can promote attrition and even abfraction of front teeth. Last not least the exposure and alignment of retained teeth can easily be characterized as a medical treatment. Such medical aspects can be found in 5-10% of each birth year. In Germany more than 60% of each birth year receive orthodontic treatment, so it can be concluded that the majority of these treatments deal with aesthetic improvements rather than medical therapy.
The consequence: Orthodontists should honestly tell their patients in a realistic manner about the special character of orthodontics as elective enhancement of physical findings. It would be dishonest to sell orthodontic treatment as necessary medical treatment fort wo thirds of each birth year. Decisive for opting for orthodontic treatment should be the individualdesire for improving tooth position. In lack of such a personal wish orthodontists should be very cautious to recommend orthodontic treatment, as there are usually no striking medical arguments in favour of orthodontics!