Tongue-tie, or ankyloglossia, is a condition whereby the lingual frenulum (stringy bit under your tongue) attaches near the tip of the tongue and may be short, tight and thick. It is potentially a concern if it limits the range of movement of the tongue, interfering with feeding or speech. Tongue-tie is present in ~4% to 11% of newborns and has been cited as a cause of poor breastfeeding and maternal nipple pain. Frenotomy (cutting/removal of the tongue tie) has been promoted to correct restriction of tongue movement and allow more effective breastfeeding with less maternal nipple pain. Rece ..read more

I have blogged previously on appliances claiming to accelerate tooth movement and shorten orthodontic treatment. One of these is micro-vibration and an appliance using this principal is AcceleDent. I have previously researched this topic during initial alignment and now Part 2 has been published on extraction space closure. I strongly believe in an evidence-supported approach to clinical practice and this study (as with all my research) was conducted in my orthodontic practice to answer the clinical question of whether this was a worthwhile technique to consider implementing for my own pat ..read more

In orthodontics, the current trend is to find ways to accelerate treatment with many appliances making these claims, even in the naming of their appliance or technique (Fast, Quick, Rapid, Speed, 6-month, etc.). There is substantial evidence now to demonstrate that simply changing to a different type of bracket makes no difference – it is the skill of the operator that is most important, otherwise the patient may be accepting a compromise. For example; if treating only in round wires then the roots are not rotated, tipped or especially torqued into their best and most stable positions or the ..read more

I recently wrote a review article in the Australian Dental Journal supplemental issue on accelerated orthodontic treatment. In it I discuss the many claims by manufacturers of several appliances and proponents of various techniques that claim to accelerate treatment. This appeals to both the patient’s and the clinician’s desire to ‘speed’ up and shorten their treatment, however how strong is the evidence or is it just marketing hype? I am a little concerned as it would appear that in some respects, advertising claims in orthodontics are following down the path of the exercise fads claiming r ..read more

This summary of my recent clinical trial published in the American Journal of Orthodontics & Dentofacial Orthopedics demonstrated no effect of the AcceleDent Aura vibrational appliance during the initial alignment of teeth with fixed appliances ..read more

Some clinicians advocate very early treatment in the primary (~ages 3-5) dentition and recommend interventions claiming they will prevent future orthodontic problems. But what if we did nothing and observed them? This very interesting article from Sweden followed 277 children from age 3 to age 11.5 and evaluated the presence of malocclusion, sucking habits, breathing problems, allergies and trauma over time. There was quite a high prevalence of malocclusion at age 3 of 71% and although this improved by age 7 to 56%, it worsened again to 71% by age 11.5. However ~45% of subjects were conside ..read more

The timing of treatment of Class II (protrusive top teeth &/or retruding lowers) patients has been debated for many years in orthodontics with some claiming you need to treat early, even as young as 5-8 (discussed in a previous Blog) or 9-10 or wait until 12-13! Several indicators have been used to assess the ideal timing and a more recent one is the Cervical Vertebral Maturation method (CVM) which uses the maturational stages of the cervical vertebrae in the neck on a cephalogram x-ray. The CVM method was first developed by Don Lamparski along with Maria O'Reilly at the University of P ..read more

This Blog topic was prompted by comments in Kevin O'Brien's excellent Blog regarding 'thinking about orthodontics'. Kevin was discussing evidence-based care and what we know versus what we don't know and how to apply our knowledge, skill and experience as clinicians in the treatment of our patients. Many suggestions were made about what we do and don't know but two comments in particular claimed that Passive Self-ligating (PSL) brackets were superior to conventional brackets during initial alignment in non-extraction treatment. I have also seen other claims in Facebook study clubs where the c ..read more

For this Blog I thought I would recap the 5 most popular Blogs I have published so far and it is interesting to note that they are all related to early #orthodontic treatment. Although some of these involve the same topic I will rank them in order of the most viewed individual Blogs. Note the text in a different colour is a link to the original Blog or document so just click on it if you wish to know more. 1) The most read and searched Blog and also one of the more recent was 'Maxillary Expansion - Unexpected Benefits?' in September this year. This Blog has interest for readers wh ..read more

One of the most popular topics in my series of Blogs has been on prefabricated #Myofunctional appliances and so I thought I would share the results of this randomized clinical trial from Sweden which was presented at the recent 8th International Orthodontic Congress in London. The complete abstract is below and follows on from their paper reported at the 7th IOC in Sydney in 2010 which I reported here. The conclusions reinforce that the overjet/protrusion correction obtained with the prefabricated Myobrace was dental/tipping of teeth while the custom made #Activator appliance  ..read more