Why have orthodontic treatment?

You may think the answer to that question is easy, you have crooked teeth, so you need them straightening with orthodontic treatment. But why should we straighten teeth? This paper published in the current BDJ looks at the value of orthodontic treatment, and I found it a really interesting read.

I often quote the three main reasons for orthodontic treatment as dental health, dental function and aesthetics. For the majority of people with crooked teeth function (eating and speaking) is not a problem. Anyone with significant impairment, such as a lisp, is likely to find that orthodontic treatment alone won't solve the problem. Whilst patients tend to perceive that their teeth will be easier to clean and keep healthy when they are straighter, the evidence for straight teeth being healthier than crooked teeth is very poor. Leaving aside a few dental health issues such as buried teeth that only affect a few individuals, this leaves aesthetics as the prime reason for carrying out orthodontic treatment.

So why should the NHS continue to fund orthodontic treatment for children if it isn't going to bring an improvement in health? The paper states that about 10% of the NHS dental budget was spent on orthodontics in 2010-2011, amounting to £248m. That's a lot of money for something that could be considered cosmetic. Are patients being 'vain' when they seek dental treatment or is there more to it than that?

A different way of looking at this is to explore the effect of crooked teeth into psychological and social well-being, which this paper addresses. Psychological well-being could be considered the person's own view of themselves, but is affected by many things and the impact of a single factor like teeth is difficult to measure. Social well-being is how easily the person interacts with others, so this could include school, work, friends or significant others. The importance of these values and their measurement is a growing area, and patient reported outcome measures (PROMs) are becoming more widely used.

One paragraph in the conclusion really stood out for me. Many of my patients tell me how much happier they feel since having their teeth corrected, especially in meeting and interacting with people. The value of this cannot be underestimated, and confirms that although something might be considered to be an aesthetic problem, rather than a dental health problem, it isn't necessarily less important.

"The main value of orthodontic treatment is to allow individuals to cope more effectively in social situations, without concern for the appearance of their teeth. In a health service context this is wholly compatible with the WHO definition of health as 'a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity'."

The NHS funds orthodontic treatment for children with severe enough problems (how severity is measured is a different subject)), and I do hope this continues to be the case, even though I don't personally have an NHS contract. But for adults or children that have milder problems orthodontic treatment can still bring a valuable change. So please don't think you are being vain in seeking treatment, if your teeth are affecting how you see yourself or how you interact with others it could have a greater effect on you than you think.

What is the value of orthodontic treatment?

P. E. Benson, H. Javidi & A. T. DiBiase
British Dental Journal 218, 185 - 190 (2015)

New Year's Resolutions

Have you made a New Year's Resolution? The start of a new year always seems a good time to start or regain good habits. I'm sure many will have some sort of resolution to improve themselves, whether it be a diet, giving up smoking or being more organised.

I'm not one for resolutions myself, though I have promised myself I will spend more time doing the jobs I keep putting off as I'm an excellent procrastinator, so I suppose that's a sort of resolution!

How about a resolution that's easy to keep, will make you feel better about yourself, and will make other's feel better too? You might think that doesn't exist, but how about if you resolve to smile more? The simple act of smiling will instantly make you feel better and will make other people smile back. It's a universal language that you can use to communicate with anybody, friends, family or strangers. There's even research that suggests smiling will relieve stress, boost your immune system, lower your blood pressure and make you look younger. Have a look at this list of 10 reasons to smile.

*Edit* The same day I published this blog the Guardian wrote this article about how smiling is now fashionable! No longer do cover models on magazine's have sullen faces, they are showing their teeth in big smiles! Not just models, Kate Middleton is at it too (yes, her again!). I particularly like the final paragraph "Still, on the plus side, this is a fashion you can wear for free (memo: must book dentist appointment), and that suits me."

If you don't feel like smiling ask yourself why. Many of my clients tell me they always keep their lips closed when smiling, hide their mouth behind their hand and avoid being photographed. Are your teeth stopping you smiling? Perhaps 2012 is the year to do something about this?

Why not make your New Year's Resolution to find out what can be done to improve your smile? Simply call your dentist or orthodontist for a consultation. Many people think they are beyond help but there is always something that can be done and often it's not as difficult as you might think. If you're unsure about the difference orthodontics can make take a look at our 12 Smiles of Christmas to see some of our transformations over the last year. If you'd like a similar consultation please just get in touch and arrange a consultation or a complimentary visit with our treatment coordinator, and by New Year 2013 you could have a completely different smile!