The effects of orthodontic treatment on the soft periodontal tissues

Abstract

It is likely that a few persons may have been disturbed by some of my remarks. If anything that I have said is construed as being critical of orthodontic education or orthodontic practice, it should be remembered that these comments have been made only in the hope of enhancing this specialty as a learned discipline within dentistry. We should be ever mindful that you must be first and always good dentists and then good orthodontists. As orthodontists, you enjoy the privileges of a recognized specialty and you must assume the increased responsibilities pertaining thereto. This includes a background in the basic sciences of greater scope and depth than that required for the practice of general dentistry. This background in the sciences basic to dentistry and to the rational practice of orthodontics as a learned specialty is essential for the conduct of the research that is so important for the development of new knowledge which can result in the perfection of still more rational diagnostic and therapeutic procedures. As a dental educator, I am truly concerned about the general lack of emphasis placed on the basic sciences in all advanced education programs. Apparently, Dr. Mershon was likewise concerned in 1922. In most programs the basic sciences occupy a position of minor importance or one that can be more accurately described as academic window dressing. This lack of adequate instruction and understanding of the basic sciences is one of the significant weaknesses of any preceptorship program. True specialty status today requires much more than increased clinical proficiency and experience. The rapid strides made in recent years by the periodontists, who are also intimately concerned with the periodontal ligament and the alveolar process, have furnished the basis for newer and more effective methods of treatment. It is suggested that much of this newer knowledge could be integrated into orthodontic practice to the advantage of both the orthodontist and the patient. The recent studies by Fish on the gingival “col” and those by Erikson and others on the constancy of the transseptal fibers and the persistence of the elastic components of the transseptal fibers appear to be of great significance in orthodontics. It is suggested that much more attention be given to occlusal adjustment by selective grinding, sometimes before the active phase of tooth movement but certainly before attempts are made at retention. It is sincerely believed that this will result in more effective and comprehensive orthodontic services and, in addition, there will be far less likelihood of periodontal breakdown in later years. Orthodontists, along with all other members of our profession, should place greater emphasis on the maintenance of optimum states of oral health. With proper emphasis on adequate oral physiotherapy, there is little reason to believe that the presence of a properly placed and adjusted orthodontic appliance represents a serious hazard to the health of the gingival or periodontal tissues. It has been a great honor to be invited to present this Mershon Memorial Lecture. I hope that some of the ideas and comments that I have presented may in future years enhance the specialty that was so much a part of “Uncle John's” life and to which he contributed so generously.