In my last blog, I shared that do-it-yourself consumer orthodontics is our new reality. Our profession’s best response is to provide a more comprehensive level of service—one that addresses the patients’ total health—more than just cosmetic enhancement. There have been many interesting health-related dental developments over the last three decades including
- The treatment of airway problems in adults and children;
- Better diagnosis of TMJ dysfunction with sophisticated procedures and equipment
- Orofacial myology including an appreciation of tethered oral tissues
- Cone beam computed tomography as an adjunct in orthodontic diagnosis
- Magnetic resonance imaging.
These phenomena are the result of experienced practitioners striving to address patient needs that could not be met within the old paradigm. They are also indicators of bigger, more subtle biological forces at work. Collectively, they offer vital clues to a very different way of viewing the body. Yet, as a profession, we persist in a classic Newtonian-mechanical approach to straightening teeth. This mechanical approach has made technical innovation easier, resulting in a stream of intraoral devices which have culminated in DIY orthodontics. Somehow, in this process, the patient’s greatest needs have been overlooked.
If you are like me, your mind probably boggles at the prospect of DIY orthodontics. The ramifications are profound, but rather than view this as a problem, let’s look at this as an incentive to reassess what we do professionally. How do we develop a more comprehensive and personalized approach to orthodontics?
The first step is to accept that classical mechanical principles do not apply in biology, despite the fact the majority of our techniques are designed as if they do. That is the bad news. The good news is that an alternative physiological model has developed over the last 30 years which makes far more sense once you examine the scientific evidence and accept the underlying principles. The new physiological model relies on the principle of biotensegrity.
I will share evidence to support this principle in later blogs. For now, let’s proceed with the notion that when you apply a force to any part of a biological structure, it immediately distributes the force evenly throughout the whole structure. The beauty of this principle is that it applies not just at the level of a cell, but also at that of the tissue to which the cell belongs, then the organ, and finally the whole body. Technically this is known as a hierarchical system. This is a familiar concept in the physical disciplines of osteopathy, chiropractic, and physiotherapy, but initially, the supporting explanations seemed suspiciously ”soft” to me, an evidence-based orthodontist.
Biotensegrity is a very young science. Its central concept involves a geometrical configuration known as an icosahedron, a twenty-sided sphere which combines flexibility,stability, and is highly energy-efficient, all qualities especially valuable in living organisms. If we think of a cell as an icosahedron structure it is possible to create a simplified physical model of the cell. With this model we can start to build an alternative hypothesis to that of classical mechanical theory which has dominated orthodontic thinking for so long.