The Early Days
When I started doing orthodontic treatment in the early 1990s over 95% of the patients that I was seeing were children. In fact many adults had no idea that they could even have orthodontic treatment. The thinking came from the feeling that their jaws and teeth were set in place. As time went on I would hear questions, usually from parents of younger patients asking when orthodontic treatment could be carried out. The dialogue continued to change and became “can adults have orthodontic treatment?”
As the digital age and the size of the internet grew, adults started to ask things like “Do you do lingual orthodontics?” and eventually Invisalign. Ceramic (tooth coloured) brackets have been around since the early 1980s indicating that there was an aesthetic market and a lot of adults wanting treatment at that stage would ask if they really had to have metal braces.
We have to go back to before the 1980s to see that the development of direct bonding of braces to teeth was still in its development. I remember clearly, seeing orthodontists at Birmingham Dental Hospital using metal bands on every tooth giving the patient a Jaws like look. The gradual increase in direct bonding led to it being possible to have tooth coloured brackets being used.
Now we have a far wider range of appliances that we can use and the development of virtual appliance design and 3d printing in plastic is already becoming superceded by the possibility of printing metal, biocompatible plastics to replace metals and even biodegradable plastics. There is a very exciting future for adult treatment and now we are able to discuss the use of multiple appliances, informed by the demands of the patient. While in-house aligners are of great interest, I am not sure I see this as the only future for orthodontic treatment.
Some of our adult orthodontic patients say that they have thought about aligners and feel that they would not trust themselves to wear them. They want something stuck to their teeth. The challenge then is to find the balance, based on which appliances will work best. We are now discovering that there are some situations that will be more straight-forward to control with fixed brace appliances. Others working better with aligners and others still,with lingual braces. This forms part of the discussion with our patients, and adults who come to see us are keen to engage in this kind of discussion.
The On-line Onslaught
The internet has helped and so the conversation has gone from “I didn’t know adults could have braces” to “I have come to see you because I am interested in the Incognito system because I would like lingual braces”.
The last 12 months has been a funny year for us because as an orthodontic practice we have been one of the outlets that has been able to remain open during the Covid outbreak. Added to this, people have not been able to travel or go out to restaurants, leading to disposable income. Add to this the “Zoom Effect” and we see people looking at their own faces on line and starting see things that they are not happy about but were once unaware off. This has led to a large number of people contacting us for advice.
Now that the internet has gone from Us searching It, to It searching Us, I have no doubt that this will lead to further change in the offerings both to Orthodontics and to their patients and we just have to be careful that these changes are positive, in the interests of our patients and not just for Capitalism.
Evolution in orthodontics seems to get faster every year.