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SHORT CUT OR LONG HAUL?
BY RICHARD GIBSON
Richard Gibson, Principal of Wallasey Orthodontics and Consultant
to Liverpool University Dental Hospital talks to us about dentistry.
Advances in everyday technology should make things easier or
better – but sometimes all they do is give you more decisions
to make.
Take Sat Nav for example – do you want to take the fastest or
the shortest route? Do you want to avoid the toll? The same
is true for the availability and accessibility of healthcare. Better
access and advances in technology, make people more aware
of what is possible but the initial information usually comes
from marketing literature and is more geared at grabbing your
attention than telling you the whole story! We rarely buy the
whole story – we like the headlines!
Orthodontics is a great example. There are some tremendous
marketing campaigns to sell us straight teeth, but not only straight
teeth – straight teeth in no time at all! Within the specialism this
is referred to as Short Term Orthodontics (STO) or limited aims
treatment – and it has its place but like so many things the whole
truth is important.
When a patient comes to their first consultation, one of my
questions is “what don’t you like or what would you like to
change?”. Usually, the response is fairly specific – “my front teeth”,
“I hate smiling” or “this particular tooth”. Human nature dictates
that we already start working on the solution to the problems
we are faced with and this is true here as well. The solutions
we consider are usually very targeted at the issues we notice
ourselves. As a specialist, I need to consider all the options and
present them in a clear way that allows that individual to make
an informed decision.
STO is often an option and deals with specific problems in isolation
from the rest of the teeth and bite. This means that essentially it is
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a compromise right from the start and so it doesn’t usually form
part of routine planning for the patients we treat in adolescence.
STO accepts the main features of the bite and position of the
teeth and makes limited changes (usually to the front teeth) over
a short period of time – that’s the headline. But due to the nature
of this treatment it inherently builds in instability and without
appropriate retention…forever – or as long as you want to keep
the teeth straight…the teeth will move back (relapse). It is fair
to say that even comprehensive orthodontics (where we try to
improve the bite and function of the teeth into the most stable
position) does carry the risk of relapse – but rarely do things
change all the way back to where they started (even in the most
uncooperative of retainer wearers). The opposing teeth and
surrounding soft tissues of the lips and cheeks – when in good
harmony help to maintain the stability of the result. Without this
harmony then things change more readily. That doesn’t mean
to say that STO is a poor option as it can dramatically change
peoples’ appearance, preserve healthy tooth tissue and improve
an individual’s perception of themselves. Similarly, retainers
are very manageable in both fixed and removable forms – but it
does take commitment and consistency of use for long after the
motivation to make the change has left you.
Making a decision is a rewarding experience but can only be
done with sufficient and appropriate information, so speaking
to someone who can describe all the routes - whether they be
shortest or most discreet, the issues you are likely to encounter,
diversions necessary on the way and importantly whether there
is a toll to consider – is priceless!
For more information, visit www.wallaseyorthodontics.co.uk