More Evidence Regarding the Use of Self- Ligating Orthodontic Brackets (Braces)

I recently returned from the American Association of Orthodontists annual meeting and convention held in Orlando, Florida. In addition to teaching the national board preparatory class to practicing orthodontists and residents working towards becoming board certified by the American Board of Orthodontics, I was able to attend several very interesting and informative lectures by some of the leaders in our profession. Of special note was the lecture (orthodontists were spilling out of the lecture hall to hear this presentation) by Dr. Kevin O’Brien entitled “In the Land oUncertainty is Salesman King?”. Dr. O’Brian is a professor of orthodontics and researcher at the School of Dentistry at the University of Manchester, UK. and has been a clinical orthodontist and researcher for about 30 years, with the research directed at the outcome of orthodontic treatment using randomised trial methodology.

I have included below a link to one of his articles that was discussed in his lecture, which describes the current state of research on self-ligating brackets (braces that include the brands Damon, Smartclip, Empower…). To summarize, the incoming credible research is showing the claims being made by the companies (and orthodontists) marketing these brackets are not supported. The public should be aware that aggressive direct to consumer marketing by manufacturers, which is then incorporated into many orthodontists websites, is just that- a marketing pitch without backing (and now contradictory) evidence. When these products involve making a claim of superiority (and an increase in cost), candor should be used when presenting the option of these brackets to our patients. As it stands now- there is no evidence of faster results, less sensitivity, superior results, cleaner teeth, or any of the major claims for using these brackets and their systems.

Does this mean that these braces are a bad option, or worse than traditional brackets? Of course not- I actually offer them as an option to my patients because they are very nice brackets (braces). I am just up front with patients in informing them that there is no evidence that they provide better results or a better experience than “traditional braces” (which manufactures also make unsubstantiated claims about in competition with one another, and the new technologies incorporated into them!). I believe my job as a professional is to keep up with current technology, but to be completely candid with my patients about the most current evidence if we are going to choose to use a product. Please read the article in the link below, and feel free to look up Dr. Kevin O’Brien’s blog for many valuable articles on the latest research involving orthodontics controversies, products, and treatments.

Dan Rejman, DDS, MS