Kirt E. Simmons, Orthodontic Director, Arkansas Children’s Hospital
When the parents of most current school-age children had their “braces,” it was a very different world of orthodontics. Technology, as it has in so many other fields, especially in healthcare, has had a big impact on the orthodontic field. Fifteen to 20 years ago if you wanted your child’s “crooked teeth” fixed it was pretty routine and standard. Your child received two radiographs that showed what teeth were present and the general size and arrangement of their jaws and teeth in the side, or profile, plane; impressions or “molds” of their teeth, photos and then treatment consisted of metal “braces” glued on the teeth with metal wires between them to move the teeth.
So, how has technology changed this process for current patients? Diagnostically, most orthodontists now routinely, or at least in more complex cases, get a three-dimensional radiograph, called a “cone beam computed tomograph” (CBCT), that allows the orthodontist to visualize the teeth and jaws in all three dimensions. This is exactly analogous to the “CT” that has become the standard in medicine to visualize problems in your body.
"Diagnostically, most orthodontists now routinely, or at least in more complex cases, get a three-dimensional radiograph, called a “cone beam computed tomograph"
The old “mouth full of goo” molds every kid had to endure – hopefully without vomiting–is a thing of the past in most offices, having been replaced by oral scanners resulting in a digital rendition of the teeth that can be measured, manipulated, and used for diagnosis as well as for various treatment modalities. Along with the digital photos and radiographs obtained, these records provide the orthodontista digital “model” of the patient. This digitally rendered patient can then be shared electronically with other providers such as oral surgeons or the patient’s general dentist to deliver input allowing for more optimized and integrated comprehensive treatment.
What are some of the other values of this digital model? Besides being used to provide a more informative, easily understood treatment plan and explanation of treatment options and possibilities, it can be used to order custom fitted metal “braces”, custom pre-bent wires, retainers, better surgical planning and custom orthodontic appliances.
One of the biggest advancements in these new orthodontic appliances are “invisible braces”– technically known as “aligners.” These are custom-made, sequential, removable clear plastic appliances that fit over the teeth and provide the pressure to move the teeth. Other new developments are temporary titanium “pins” that can be placed in the jaw bones to help move the teeth more efficiently or in ways not previously possible, devices that vibrate/ stimulate the teeth and bone to allow treatment time to be shortened, and minor surgery of the bone around the teeth to allow them to move faster.
For complicated cases involving major jaw surgery, having a “digital copy” allows the real patient to view a “virtual” surgery result prior to deciding on the procedure. It also allows the surgeon to visualize potential results, complications and options. In the most severe cases, there is even the potential now for three-dimensional guided surgery to precisely position the skeletal components of the head and jaws for the best result.
And let’s not leave the ubiquitous cell phones out of the technology equation involving orthodontics. Online services and mobile apps are available that allow patients/parents to schedule/change appointments, review treatment options, monitor treatment progress, record patient compliance, assess for potential sleep problems, order replacement aligners or retainers, deal with emergencies via online “how to/what to do if…” videos, chat with staff/doctors/other patients, make payments or review payment plans. Many offices also employ technology for marketing, having an online social media presence with blogs by the doctor or staff, including videos, online contests and other content. Technology continues to realign orthodontics to create a better outcome for patients in every category.