The Oxford English Dictionary defines efficiency as “achieving maximum productivity with minimum wasted effort or expense.” Orthodontic pioneers have continuously sought methods of enhancing treatment efficiency by attempting to reduce the duration of orthodontic treatment and the length of orthodontic appointments. 1 Stolzenberg J. The Russell attachment and its improved advantages. Int J Orthod Dent Child. 1935; 21: 837-840 Abstract Full Text PDF Scopus (57) Google Scholar Although mean treatment times of 1 to 2 years are now typical, the drive to reduce orthodontic treatment duration persists. 2 Turbill E.A. Richmond S. Wright J.L. The time-factor in orthodontics: what influences the duration of treatments in the National Health Service practices?. Community Dent Oral Epidemiol. 2001; 29: 62-72 Crossref PubMed Scopus (48) Google Scholar , 3 Richmond S. Andrews M. Orthodontic treatment standards in Norway. Eur J Orthod. 1993; 15: 7-15 Crossref PubMed Scopus (52) Google Scholar Many techniques and appliances, including surgical techniques, 4 Wilcko W.M. Wilcko T. Bouquot J.E. Ferguson D.J. Rapid orthodontics with alveolar reshaping: two case reports of decrowding. Int J Periodontics Restorative Dent. 2001; 21: 9-19 PubMed Google Scholar vibratory stimulation, 5 AcceleDent. Available at: http://acceledent.com/images/uploads/AcceleDent+Increases+the+Rate+of+Orthodontic+Tooth+MovementResults+of+a+RCT+Final+for+Print+November+14+2011. Accessed July 5, 2012. Google Scholar increased customization of wires and brackets, 6 Saxe A.K. Louie L.J. Mah J. Efficiency and effectiveness of SureSmile. World J Orthod. 2010; 11: 16-22 PubMed Google Scholar eschewal of integral treatment phases, 7 Six Month Smiles. Available at: http://www.6monthsmiles.com. Accessed July 5, 2012. Google Scholar and routine avoidance of extractions, continue to be proposed with the expressed aim of furthering this progression. The most high profile of these developments has been self-ligating brackets. 8 Damon System. Available at: http://www.damonbraces.com/choose/index.php. Accessed July 5, 2012. Google Scholar Unfortunately, the marketing of self-ligating brackets has courted controversy, with some advocates overly optimistic about the potential effects and, consequently, overlooking or ignoring the findings from clinical research studies. 9 Peck S. So what's new? Arch expansion, again. Angle Orthod. 2008; 78: 574-575 Crossref PubMed Scopus (14) Google Scholar , 10 O'Brien K. Sandler J. In the land of no evidence, is the salesman king?. Am J Orthod Dentofacial Orthop. 2010; 138: 247-249 Abstract Full Text Full Text PDF PubMed Scopus (19) Google Scholar In this article, we will review the evidence for many of the claims made by those who promote self-ligating brackets, even in the face of recently published clinical research. Self-ligating brackets increase treatment efficiencyAmerican Journal of Orthodontics and Dentofacial OrthopedicsVol. 143Issue 1PreviewSince an early stage in the development of self-ligating brackets, authors have proposed advantages in relation to treatment efficiency.1-4 Increased efficiency can be defined as achieving a result that is as good or better, with an increase in factors that are valued by the provider or the recipient of a service. In orthodontic treatment, these factors could include fewer appointments, shorter appointments, more comfortable treatment, practical procedures that are technically easier for the clinician or the patient, less need for extractions, and less pain or anxiety for the patient. Full-Text PDF