TheProgressionoftheAspectsandComponentsofOrthodontics

OliviaRasbornik

EnglishIIIHonors
Mrs.Kopp
February26,2014


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OliviaRasbornik
Mrs.ChristineKopp
EnglishIIIHonors
26February2015
TheProgressionoftheAspectsandComponentsofOrthodontics
Walkingthroughtheorthodontistsdoorsforanappointmenthappensoftenforthe
majorityofpeople.Mostseektheperfectsmile,butclientsfailtorealizethatproperalignment
ofonesteethsolvesmoreproblemsthanjustcosmetics.Problemsregardingspeech
impediments,insomnia,jawmisplacements,andpainfuloverandunderbitesfallontothetodo
listofanorthodontist.Thesetaskswentthroughnumerousadaptationsanddevelopmentseven
now,newmethodstosolvetheproblemofmisalignedteethemerge.Asthefieldoforthodontics
continuestoadvancethroughtechnologicalprogress,suchasInvisalign,newappliances,the
studyoftheperspectiveofadolescents,andadvancesinsurgicalprocedures,correctivedentistry
providesadesirablecareerchoiceforprospectivedentalstudents.
Throughyearsofpracticewithmultipletrialanderrorexperiments,themethodsinplace
todayresolveawidevarietyofdentalcomplicationsduetotheirpreviouslystudiedprocedures.
Historically,thefirstrecordsoforalcaretracebackto7000BCwiththediscoveryofpapyrus
scrollsfoundinEgypt.TheunearthingofteethinPakistanwithstrangecrevicesresemblingthe
marksofdrillingalsogaveinsighttopastpractices.Later,archaeologistsretrievedcrownsfor
chippedordamagedteethfromEtruscanremnantsinthe7thcentury(Dentistry1).Most
ancientcivilizationsexpressedsomeinterestfordentalcareandastheirpopulationsexpanded
anddispersedintoothercountries,theirpracticesfollowedthem.
Dentistrybegantospreadasa


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wellknownandhighlydesiredpractice.D
uringtheMiddleAges,officialadministratorsof
dentalcareestablishedtheirpractices.Severalpeopleimpactedtheearlydentistryindustrywith
theircontributions.
Albucasis,anancientSpanishMoor,
detectedcalculusbuildupand
discoveredhowitaffectedteeth.Fromthis,hedesignedavarietyoftoolsmadeforscrapingand
scalingtocleanthecrevicesandsurfacesinthemouth(Siegel14).Hebecameaforerunner
due
tohisincreasedlaborindevelopingvarioustools,gadgets,anddentalaccessories.Hismethods
soonwererecognizedasadvanced,especiallysincehelivedduringthe10thcenturyA.D.
TheseancientmethodsquicklyspreadthroughEuropeandjumpstartedaneverlastingpractice
presentinmanycivilizations.

TheFrenchpickeduptheprofessionduringthe14thcentury.Thedentistscalled
themselves
dentatores.
Onemanstoodoutfromtherest,PierreFauchard,duetohisincreased
interestandstudyofthemouth.Hedevelopedatypeofdrillwhichhecouldmaneuverby
twistingwithonehandandguidingwiththeother(Siegel14).
Fauchardearnedthetitle
founderofmoderndentistryasaresultofhisstudyoffillingsandotherdentalappliancessuch
asdentures.Heusedavarietyofmaterialsincludinggold,lead,andtin,whichwereverypainful
andexpensivetoapply.Eventually,theGermansdevelopedanewmethodofcreatingdentures
withplasterofParis,amilkywhitesubstance,whichefficientlyincreasedcomfortabilityand
economicsustainability(Dentistry1).Asdentistryevolvedintoamorecomplexfield,
cracked,damaged,orpainfulteethbecameincreasinglyeasiertofix.Becausethenew
advancementsmadetheprofessionmoreappealing,anoccupationindentalhealthpickedup
popularityandcarrieditsmethodsintothe15thcentury.


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DuringthetimeofFeudalism,knights,andcastles,dentistrytransformedfromahobby
intoastudiedprofession.TheMiddleAgessystemofteachingthroughapprenticeshipappliedto
allyoungmenwhowishedtodevelopnewskillsanddiscovertheartsoftheirdesiredtrade.
Somechosecarpentry,farming,orpeddling,whileotherschosemedicallyinspiredcraftssuchas
dentistry.Thebasicrequirementsforofficiallygraduatingtheirapprenticeshipinvolvedatleast
fiveyearsoftrainingalongsideofthemasterdentistandtheotherapprentices(Siegel14).With
theirestablishedgroupofyoung,futuredentists,theytraveledaroundtodifferenttownsvisiting
eachacoupletimesayear.Thesepractitionersmainlyperformedtasksrelatedtofillingcavities,
extractingteeth,andconstructingdentures.AstheMiddleAgescametoanendandtheTudor
timeperiodemerged,thedentistryprofessionexpandedevenfurther.Dentalhygieneslowly
incorporateditselfintotheeverydaylivesofthosewholivedduringthattime.
DuetotheincreasedtradewithEasternnations,importedgoodsweresoughtaftermore
thanlocallyproduceditems.Oftheseimportedgoods,sugar,aninternationaldelicacy,rose
abovetherestandevolvedintothemostdesiredproductthatonlythewealthycouldobtain.
Duringthissugarholicstage,theenglishnoblemenfailedtorecognizetheharmfultradeoffof
usingsugar.Dentiststodayoftenpreachagainstexcesssugarconsumptionbecauseitinevitably
leadstocavities.Astheupperclassingestedmoresugar,theirteethsufferedfromcorrosion,
producingunsightlyholesthatservedasaperfecthomeforalltypesofbacteria.Thisledto
extremetoothdecayandeventualfalloutwhichopenedupaneedfordentalcaretakers.The
dentistsoftheTudortimeperiodactuallydoubledasbarbersandcarriedoutallactivities
requiringablade(Worsley1).Theyofferedavarietyofdentalassistancesuchassurgeryand
toothextraction.Mostshockingly,theyperformedsomethingsimilartoapresentdayheart


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transplant.Whenapproachedbyawealthyaristocratpresentinganunsolvabletoothproblem,
thebarber/surgeonwouldhireamemberofthelowerclasswillingtogiveuponeoftheirteeth
formoney.Thebarberwouldextractahealthytoothfromthelowerclassindividualandthen
wouldpulltheinfectedtoothofthepatrician.Thebarberwouldinsertthehealthytoothintothe
openspaceforthenoblemenandwithinthecourseofanhour,thetransplantwascompleted.
Thisabominablepracticecontinuedupuntiltheearly1800showever,thisendedwhendoctors
figuredoutthatdiseasessuchassyphiliscouldbetransmittedthroughthispractice(Worsley2).
Thismethodcausedanawarenessfordentalhygienetospreadandshortlyafter,thefirst
toothbrushesandtoothpastewereproduced.Toothbrushesstartedoffastwigsorbranches,even
cuttlefishwasrubbedonteethtoevenlyspreadthetoothpastewhichconsistedofwater,salt,and
rosemarymixedthoroughlytogether.Eventuallyasthepracticeprogressed,horseandpighair
wereattachedtosticksforamoreeffectiveclean(Worsley2).Thesemethodsadvancedslowly,
buttheyneverdisappearedbecausemostwishedtomaintainatoothy,whitesmilewhichstill
existsasamajortrendtoday.Becauseoftheimportancepeopleplacedondentalhealthinthe
past,presentdaydentistrytakescareofmanyinfectionsandcomplicationsthatpreviouslydealt
withcasescouldnothavesolved.
Fromtheincreasedstudyanddevelopmentofdentistry,multiplecareerseventually
branchedoffandevolvedintotheirownfields.Theprofessionalsamongthesefieldsinclude
prosthodontists,oralsurgeons,labtechnicians,dentalassistants,andorthodontists.Alldealwith
significantareasintheworldofdentalhealth,butorthodontistsstandsoutforseveralreasons.
Themainobjectivefortheorthodonticprocessistocorrectthealignmentofteethwhichopens
uptheopportunitytoproperlycleanteeth,tofixspeechimpediments,todecreasethechanceof


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injuryfromprotrudingteeth,andtoincreaseselfconfidencebycreatingahealthierappearance
throughcorrectlyalignedteeth(WithCare,TeethCanLastaLifetime1).Themostcommon
solutionforanyofthepreviouslylistedissuesusuallydealswiththeapplicationofbracesor
otherorthodonticfixturessuchasherbst,spacers,oratypeofheadgearthatlookslikea
facemask.
Inordertoadministertheseappliancespreciselyandeffectively,potentialorthodontists
mustattendoneofthe55dentalschoolsavailableintheUnitedStates(Siegel15).Acceptance
intooneofthesedentalschoolsrequirestheminimumofahighschoolgraduation,aresume
filledwithcommendablefactors,apassinggradeontheDAT(DentalAdmissionsTest),and
fouryearsofcollegiatestudywithamajororminorinascientificfieldsuchasbiology,
chemistry,biochemistry,physics,orevenmarinebiology(Wilhite).Applicationssubmittedto
theschoolsgothroughanintensereviewingsession.Ifselected,onemustagreetoaninterview,
thefinalstepintheadmissionsprocess.Topdentalschoolsfilteroutanystudentswholack
confidenceandcertaintybyusingthismethod.Oncetheincomingclassofdentalstudentshas
beenselected,theacademicrigorbeginstopickup.Professorsteachallaboutthetheformation
anddevelopmentoftheprimaryteethsothattheirstudentsmayunderstandtheemergenceofthe
permanentteeth.Theyalsodemonstrateavarietyofproceduresnecessaryformoderndentistry.
Furtherintodentalschool,theundergraduatesmustpartakeinthedissectionofanactualhuman
body.Inordertoattaintheirgeneralistsdegree,studentsmustmaintainpassinggradesand
demonstrateadesiretosucceed.Aspiringorthodontistsmustearnthisdegreeafterfouryearsof
dentalschoolwhilestayinginthetopfivetotenrangeoftheirclass(Wilhite).Thesestudents
areconsideredforacceptanceintofouradditionalyearsofspecialistschool.Duringspecialist


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school,avarietyoforalproceduresaretaughtandmastered.Dependingonthebranchoforal
health,acertaintypeofdegreeisawardedtothespecialtyschoolgraduatesandoncefinished,
theymayventureouttopracticetheirprofession.Thestartupphaseofanyonesoccupation
challengeseventhemosttalentedprofessionals,usuallyduetofinancialreasons.Thecostof
themanyyearsofschoolalongwithtextbooksandlabfeesaddstostudentloansanddebtowed
(Wilhite).Thistendstokeeprecentgraduatesfrombuildingtheirownbusinessfreshoutof
dentalschool.Themajorityofalumsresulttoworkinginanalreadyestablishedorthodontic
facilityuntiltheygainenoughfinancialstabilitytocreatetheirownbusiness.Theprocessof
becominganorthodontistrequiresextensivelearningandfinancialinput,butprovidesa
substantialandenjoyableoccupationinthelongrun.
Orthodontistsregularlyattendtothecommonmalocclusions,protrudingteeth,and
misalignedbitesbyshiftingteethintothecorrectposition.Themajorityoforthodontic
professionalsutilizebraces,themosthighlysoughtaftermethod,foralteringtheappearanceand
functionoftheirclientsteeth.Theprimaryagesgroupswhoreceiveorthodonticcareinthe
formofbracesrangefromtwelvetoseventeen,dependingonthedevelopmentofpermanent
teethandthelastsetsofmolars(Siegel82).Initiatingtheapplicationofbracesinvolvesa
consultationwithanorthodontistwhowilltheninterviewthepotentialcandidatetoevaluatethe
currentstateoftheirteeth.Inordertoproperlycommencetheactivephaseoforthodontics,the
clientabsolutelymustresolveanyharmfuloralhabitspriortotheapplicationofbraces.This
ensuresthattheorthodontistworksonlywiththeinformationtheyreceiveduringthe
consultationwithoutanyunseenissues.Toaccuratelyjudgethecurrentpositionandalignment
oftheclientsteeth,theorthodontistmustexaminethelocationsofteethandmusttakenoticeof


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anyabnormalities.Afteracarefulinspection,XRaysfromapproximatelyfourdifferentangles
areproduced.Thisessentialstepintheprocessprovidestheorthodontistandtheirassistantsa
startingpointtobasetheirclientsprogressoffof.
Oncetheconsultationstageiscompleted,theorthodontistmustinspecttheXRaysthey
receivedinordertodecidewhichprocedurewouldcorrecttheirclientsmisalignedteethinthe
mostefficientmanor.Afterthemethodhasbeendetermined,thepatientmustcomeinforan
appointmenttoinitiatetheactivephaseoftheirorthodontictreatment.Duringthisphase,the
orthodontistcouldapplyvariousorthodonticdevicessuchasbrackets,wires,herps,orspacers.
Theseperfectthealignmentandlocationsoftheteethalongwiththepositionsofthejawbones
tocreatethedesiredresult(Wilhite).Thepatientmayneedtowearorthodonticappliancesfora
yearormoredependingontheinitialconditionpriortotreatmentandthecomplianceofthe
client.Theconsentofthepatiententirelyaffectstheoutcome.Withoutpropercare,thepatient
couldeventuallyprolongtheprocesswhichmostdesperatelytrytoavoid.Themajorityofcases
wheremistreatmentoccursusuallyinvolveseatinghabits.Orthodontistshighlyrecommend
eliminatingallfoodsthatcouldknockoffabracketordisconnectoneofthewiresusedinbraces.
Thesefoodsincludepopcorn,wholeapples,hardcandies,andoverlysweettreatstoavoidother
dentalproblemslikecavitiesorgumdisease.Followingtheinstructionsgivenbythe
orthodontistdrasticallydecreasesweartimeandleadstothemosthighlysoughtafterfunction
andappearance.
Despitetheendlesslistofbenefitsthatoriginatefrombracesorotherformsof
orthodontictreatment,complicationsarisebecauseofthementalimplicationsthatcomewith
them.Someluckyindividualsdonotmindthemetalapplianceswhileothersdreadeventhe


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thoughtofgoingthroughtheprocess.Someorthodontistsfailtorecognizethisbecausethey
focussodeeplyontheprogressionoftheteeth.Theprimaryagesgroupsfororthodontic
treatmenttendtoinvolveadolescents.Thisstageinlifeisusuallyassociatedbytheawkward
yearsofdevelopingandmaturingintoyoungadults.Mostsaythatthoseyearsaccompanyan
arrayofchangingemotionsregardingselfimageandappearancewhichresultsinmanyproblems
whenitcomestoorthodontics(Vaida1).Fromachildsperspective,theyviewbracesorother
devicesasharmfulandembarrassingwithoutacknowledgingthevariousbenefitsprovided.This
tendencyaffectsthecomplianceneededforthedesiredoutcomeandobscurestheestimatedtime
requiredforthetreatmenttobecompleted.Becauseofthis,orthodontistsmustconsiderthe
psychologicalelementsoftheirregimen.Astudyconductedbyateamofpsychologyexperts
fromtheJournalofHumanandVeterinaryMedicineheadedbyprofessionalLigiaVaidastates
thattheorthodontistmustmeetthepatientsmedicalandpsychologicalneedsinorderto
improveandtopreventadaptingdisorderthatmightoccur(1).Inordertoproperlykeepthe
finalproductensuredofitssuccess,methodsformaintainingthelevelofadequatenessinthe
clientmustbeinstalled.
Themosttroublingaspectoforthodonticsrevolvesaroundthepsychologicalelements
mainlyinadolescents.Problemswithbracesresultfromtheissuesofselfimage,butwiththe
properattentiontodetailmanyofthesecomplicationscoulddissipate.Onewaytowelcomea
funsidetotheworldoforthodonticsconcernstheappearanceofthebracesthemselves.
Orthodontistsmustwrapbandsaroundthebracketsinordertokeepthemsecurelyattachedto
thewires.Companiesthatproducedorthodonticfixturesbegantoconstructbandsthatwere
availableinavarietyofcolorsandevenpatternsthatthepatientscouldchoosefrom.Withthis


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outbreakofneworthodonticfashion,someexcitementworkeditswayintothepatientsnowthat
theycouldfeelapartoftheirtreatment.Temporaryretainersdebutedasanothertrendyappliance
becausetheycouldswitchtheordinaryclearorcreamcoloredplasticoutforbrightlycolored
printsandpatterns(Marlene1).Someorthodontistsevenincludelogosamongtheselection.As
simpleastheyseem,thesedevelopmentssupplyorthodonticpatientswithamoreinteractive
experiencebyallowingthemtofeelliketheypossesssomecontroloverthesituation.
Althoughorthodonticpracticesmakemorestylefriendlyoptionsandotherchoicesfor
thedesignofvariousappliancesavailabletotheirclients,bracesoccasionallydeterpotential
candidates.Thiscausedsomeorthodontiststodeviseaplanforanalternativetobraces.After
yearsofstudyandtrialanderrorexperiments,thefinalproducthadbeencreated.In1998,the
makersofInvisalign,AlignTechnology,securedconfirmationfromtheFDAsotheycould
initiatetheadministrationoftheirinvention(FogelandJanani1).Invisaligndevicesappearas
clearretainersthatconcealthemselveswhilebeingworn.Inaddition,theyofferthesameresults
asbracesjustwithoutthemetalbrackets.Orthodontistsaroundtheworldjumpedatthe
opportunitytopartakeinthedebutofthenewadvancementintheirfieldandsoonthepopularity
ofInvisalignhadincreaseddrastically.In2007,AlignTechnologyrecordedthenumbersof
currentinpracticeusersofInvisalignandtheyconcludedthatanaverageofabout48,130
dentistsandorthodontistsaroundtheworldwerespeciallytrainedandauthorizedtodelivertheir
devicetoclients(FogelandJanani1).
YoungadultsserveastheidealcandidatesforInvisalignduetotheincreasedneedfor
commitmentduringtreatment.Asalways,thecurrentstateandpositionoftheteethdetermines
thetimespentwearingtheretainers,buttheaverageweartimeforInvisaligntendstostay


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betweenthirteentofourteenmonths.However,severemalocclusionsorotherextremecases
couldresultinatwoandahalfyearlongtreatment,probablyoneoftheonlydownfallsof
Invisalign.Ontheotherhand,anewwaytoexaminetheprogressionofteethalsoemergedwith
theinventionofInvisalign.Clincheck,anexclusiveprogramcreatedbyAlignTechnology,
providestheusersofInvisalignwithsoftwarethatallowsorthodontiststodigitallyinspecteach
stageoftreatmentwith3Dimages.Itprovidesanestimatedweartimewhilealsogiving
suggestionsfortypesoftreatment(FogelandJanani2).Thisnewtechnologytakeshoursoffthe
taskofdecidingmethodsfortreatmentonthepartoftheorthodontistwhilealsotransformingthe
clientsappearanceinthemostefficientmanor.
Thefieldoforthodonticscontinuallygoesthroughincrediblestagesof
developmentduetotheincreaseoftechnologicalknowledge.Invisaligntendstoberecognized
asthemostcommonandmostrecentadvancement,butothermachinesandgadgetsdeservejust
asmuchattention.AcceleDent,acompanythatproducesdentalappliances,recentlycreateda
devicethatpromotescellgrowthinosteoclastsandosteoblaststhatarelocatedneartheteethand
jawbones.Theirproduct,whichgoesinsidethemouth,releasesmicroscopicvibrationswhich
sparksgrowthandmovementintheteeth.Designedtobewornalongwithbraces,thislittle
gadgetactivatesthecellswhichhelpstheteethtorespondrapidlytothepressureofbraces.On
averageofthreemillimeterspermonth,theteethmaymoveuptothirtyfivepercentfasterthan
theynormallywouldwithoutthedevice(Wilhite).Thiscoulddrasticallydecreaseweartime
whichappealstomanyorthodonticclients.Anotheradvancementinvolvestheuseoflasersto
stimulatethegrowthofstemcellsinordertorepairdamagedteeth.Thisallowsforafaster
operationwithsignificantlylesspaincomparedtothecommonpracticeofdrillingandfilling


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holesorcracksindamagedteeth(ForgettheDrill,FetchMetheLaser1).Otherformsof
progressincludetheadvancesmadetoradiographsbyusingXRays.TheseXRayshavethe
capabilitytoreplacethemoldsusedforanalyzingtoothstructureandpositionwhichmeansthat
orthodontistswiththis3Dprinterdonotneedtomakeimpressionsoftheirpatientsteeth.The
manufacturer,iTero,developedthismachinesothatthetimeconsumingandfalliblemethodof
fillingtrays,takingtheimpressions,andformingmoldstransformsintoamoreefficientand
reliableapproach.
Orthodonticswillalwaysplayaroleincommunitiestodayduetotheessentialproperties
itpossessessuchastheabilitytoalignteethandtherebyallowingonetoproperlymaintaina
healthymouth.Throughoutthehistoryoforthodontics,knowledgeofdentalhealthhas
transformedintothetheprofessionmanyexperiencetoday.Thenecessityoforthodontics
guaranteesaspotforanyhardworkingstudentwhoexpressesaninterestindentaloccupations.


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