Our Blog

Do-it-Yourself Orthodontics!!!

November 1st, 2018

Welcome back everyone.  While there are still so many topics to discuss, I wanted to briefly touch on one of the newest, and worrisome, fads today in Orthodontics.  

Most likely you have read/heard about Direct-to-Consumer (D2C) companies.  To make sure everyone is on the same page, I will briefly explain.  D2C companies are those that market their goods and services directly to the public.  There are no middlemen (think stores), and as such they are able to reduce their costs AND therefore sell their products more cheaply.  

For this reason D2Cs have exploded in popularity.  Chances are you have heard of (if not bought from) some of the most successful D2C companies.  Do the names Casper (mattresses), Warby Parker (glasses) and Dollar Shave Club sound familiar?  For the record I have purchased items from some of these companies and am thrilled with their products.  Alright, now that we are all caught up…

Dentistry and orthodontics are not immune from the D2C trend.  These companies specifically market do-it-yourself (DIY) treatments.  There are dental labs that will produce snoring appliances, removable dentures, and different versions of veneers to make someone’s smile appear whiter and brighter.  Those are all treatments that have the potential to permanently change teeth, bone and gum tissue!  Even in orthodontics there are now a few companies advertising to produce clear aligners (trays) to straighten teeth!  

The American Dental Association (ADA) and American Association of Orthodontics (AAO) have both released statements regarding these D2C companies.  Obviously consumers, when using D2Cs, are bypassing the doctor’s essential role in diagnosing and treatment planning.  What could possibly go wrong with this scenario? 

Well, apparently many things have gone wrong and now the American Dental Association (ADA) is working with the FDA on helping consumers report their problems.  Check out the article here.   

In our own practice we have re-treated 5 people in the past year who have tried their luck with DIY orthodontics.  Also, one of our colleagues recently posted a video of a patient who was seeking his orthodontic expertise to correct a DIY treatment gone bad.  I was going to include it but it was recently taken down because the D2C company is suing him!  Go figure.  

Obviously we discourage anyone from pursuing DIY dental or orthodontic treatments.  Without proper oversight, these seemingly “simple” and “easy” treatments can lead to irreversible harm at worst, or simply a very expensive re-treatment at best.  Unfortunately I don’t believe we can now close Pandora’s box.  DIY treatments will remain, especially as their marketing budgets swell and consumers remain largely uneducated on the necessity of doctor-based care.  

So, why write something like this?  Well maybe you will share it with someone who is thinking about DIY orthodontics.  If nothing else perhaps it will persuade them to dig a little deeper with their research.  Consumer education is everything, and hopefully this helps.   

What I did on Vacation

July 13th, 2018

Dr. Nate here today.  So, here we are in the middle of Summer...We sincerely hope everyone has had a great start to their Summer activities!  Our whole family just got back from our yearly beach vacation, and while we were there I was finally able to catch up on the latest Orthodontic news. 

My last post focused on a supposed revolutionary vibration device designed to make Orthodontic treatment go faster.  If you want to re-visit that, click here.  I had concluded that there was no substantial evidence this system would make teeth move faster.  And now I have some semblance of vindication...

There is an Orthodontist in England named Kevin O’Brien who writes a very good blog about Orthodontics.  He is a professor of Orthodontics and a talented writer who has made quite the name for himself, even in the US.  In his most recent post (which is here) he mentioned that the British government, namely the Advertising Standards Authority (ASA), forced the company promoting their Orthodontic vibrating device to remove their ads for a very serious reason.  Instead of summarizing, I will pull the important quote.

“The ad must not appear again in its current form.  We told OrthoAccel Technologies Inc. not to make claims that their AcceleDent device could move teeth faster and reduce the pain for brace wearers unless they held adequate evidence to support such claims.”

When I finished Dr. O’Brien’s post, and then read the full ASA document, I could hardly believe it!  And then I became frustrated for two reasons.  First, the same standards haven’t been applied here in the US.  Treatments without excellent research results should not be presented to the public through advertisements!  Secondly, as a supposed learned specialty within Dentistry, Orthodontists should be able to discern good quality research from poor research.  That is our responsibility to the public...don’t treat patients with something that doesn’t work!

If you have made it this far, you should know that I fully understand that this rant has been more cathartic for me than entertaining for you.  Selfish?  Of course.  But my (and Dr. Theresa’s and Dr. Nick’s) standards are very high when it comes to treatment decisions.  Ask us why we do this treatment, and not that one.  We will be glad to tell you, and show you the research backing it up.  

New technology is great, but not always effective.  That is an important distinction. 

Some beach vacation...

Good Vibrations

March 28th, 2018

Dr. Nate here today and I wanted to discuss a new trend in Orthodontics.

Every profession chases their own ‘Holy Grail.’  It is the target at which progress attempts to hit.  Orthodontics is no different…but what IS our target?

Speed.  And more speed.  In fact, this is the most common question we hear…”How long do I have to be in braces?”  It is an appropriate question too.  Families want to get the maximum benefit with the minimum treatment time.  That not only helps the patient in terms of the final smile, but also minimizes the biggest risk of Orthodontics (think oral hygiene here).   

The quest for faster treatments has had many targets.  For example, bracket designs have been changed umpteen times and wires have been modified in both materials and sizes.  The result after roughly 75 years of tinkering…a slow, but definite decrease in treatment time.  Recently, however, speed has plateaued with traditional appliances.  More novel concepts are being developed and brought to market.

One popular product is focused on making teeth move faster with vibration.  They make a powerful assertion…use their device for 20 minutes a day and teeth will move up to 50% faster!  Amazing, right? 

But, as with anything else in the medical and dental worlds, research results are the ultimate proof of success.  As of me typing this on a very early Saturday morning there are 4 published articles on this topic.  Any guesses as to the consensus???

Three out of the four articles show absolutely no increase in tooth movement when using this vibrating device.  The one article with a positive increase (0.37mm) in tooth movement per month is barely more than the width of a human hair (0.2mm).  This apparent outlier actually has other very serious problems with their statistical analysis, and if that sounds like an interesting conversation to have let me know…

So, what is the point of all of this?  If you made it this far, here you go.  If you picture Orthodontics as a biological process (which it is), bone and bone cells are the arbiter of treatment time.  Logically, do bone cells “care” that they are being vibrated?  And is their response going to be to make the teeth move faster?  The research clearly states that the answer to both of those questions is a resounding NO. 

We obsess over the best research to determine whether new treatments are going to make a difference to our patients.  If we use it, then we can easily back up WHY.  If we don’t, well make your own conclusions.  Speed is undoubtedly important, but we NEVER compromise the quality of our treatments.  And the smiles are all the better for it. 

A Thank You to Our Patients

December 23rd, 2017

Thank you to everyone who donated their time and money to help make this year’s Christmas gift drive a spectacular success.  For the past few years we have partnered with The Haslinger Pediatric Palliative Care Center of Akron Children’s Hospital in order to do some small part in making the Holidays better for families who have a child with a serious illness. 

We are profoundly humbled by your generosity.  This is a time of year that pulls us in so many directions, and yet look at all of the presents under our tree! 

We wish you all a very Merry Christmas and Happy Holidays!  Thank you for being a part of our Orthodontic family, and we are honored to serve you. 

Sincerely,

Drs. Nate, Theresa and Nick and the Mellion Team.

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