Caries incidence in relation to orthodontic therapy

Abstract

I S THERE some verity to the generally accepted theory that prolonged orthodontic treatment means an increase in the number of cavities? If it is true, is it necessarily true? Is caries the uncontrollable effect of the other-orthodontic appliances? I believe these questions were in my mind since the early part of my orthodontic training. Experience proves that the general public almost unanimously accepts the premise that following the correction of a child’s malocclusion it is always necessary to have extensive reparative work done by the family dentist. To many it is almost as certain to happen as it is to expect that a permanent tooth follows the deciduous tooth. This feeling, justified 01 not, can be found in the family dentist. He will often jokingly remind the orthodontist-and, incidentally, the one to whom he refers all his cases and into whose hands he would trust,ingly commit his own children for orthodontic care--that when the orthodontist is through he will place crowns on all the teeth or will refer the patient to an oral surgeon. It is meant to be humor. But it is not al1 fun-in the minds of both there is apprehension-there ma.v he some truth in all this. Can we prove that if old John Jones had not, smoked as much as he did he might have lived he,vond 100 years of age instead of passing away at 87 ! Can it be proved that overcntin, 0 definitely shortened the life of Robert Smith ? To be scientific it would be necessary to hare these two characters reliye their time in exactly the same manner, except for the one alleged culprit, i.e., smoking or eating. Would Mary Brown have had as many cavities if she had not been under orthodontic treatment for two years t It is not simply a mat,ter of yes or no to any one of these questions. The noticeable absence of literature on this subject of orthodontic decay attests to its complexity. It is almost difficult to understand why so little can be found in the dental literature. Perhaps many would be-investigators have felt it futile to attempt to prove anything conclusively. The intention of any conscientiot~s and honest practitioner in a specialized field is to investigate the true value of his efforts. He asks if he is doing ever>-thing possible for his patient’s benefit. Could he do aything more 1 Ts an> harm being done? Can it be avoided or even minimized? Is it necessary? The orthodontist asks himself these same questions. There is not much to be found in t.hc literature of the last fifteen years. There are two or three investigators presently doing some private work, and