Enhancement of deviating positions of teeth and jaws


Orthodontics is a special field of dentistry. The subject of orthodontics is diagnosis and treatment of deviating positions of teeth and jaws. Whereas 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 such a concept of disease cannot readily be applied to most of orthodontic findings. Thus it is important to say that orthodontic treatment is much more enhancement than therapy, because most of the orthodontic findings are neither diseases nor do they promote the development of diseases.

Elective Treatment

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 has to be characterized as elective treatment, as non-treatment in most cases will have no medical consequences. During the last decades, orthodontists have made some efforts to establish medical causalities for orthodontic treatments.

Aesthetically Motivated Improvements

It seems probable that some extreme orthodontic findings such as the narrow upper jaw combined with lateral crossbite or the retrusion of the 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 but 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. However, with over 60% of each birth year receiving orthodontic treatment in Germany, it is easy to conclude that the majority of orthodontic treatments are aesthetically motivated improvements, but certainly not medical therapies.

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 is dishonest to sell orthodontic treatment as necessary medical treatment for two thirds of each birth year. Decisive for opting for orthodontic treatment should be the individual desire 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 our practice in Mannheim our orthodontists offer you a fair consultation on the different treatment options.


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