Pariah appliances. Greed on a way up a blind alley.

“What does she want now?” said the fish. 

“Ah!” said he, “she wants to be lord of the sun and moon.”

Brothers Grimm

Today I’d like to take a brief look at how several orthodontic appliances, and sometimes entire brands, gain a status of notorious gradually becoming an embodiment of poor orthodontic treatment.

A few months ago, a friend of mine, a maxillofacial surgeon, told me: “When I see ***** brackets on the teeth, I’m already prepared to refuse the patient”. I find it an interesting phenomena when a massive marketing – in this case of a popular type of self-ligating brackets – leads to a negative effect. Eventually, an appliance is seen as something off-putting, a warning sign.

Fishermen at Sea, 1796, William Turner

The mechanism is pretty clear. When the manufacturers push their claims over the common sense barrier, such exaggerated statements end up appealing only to certain groups of practitioners. Either inexperienced/poorly-trained orthodontists or general dentists. This is how aggressively advertised appliances land in the wrong hands. Fair to say, most of the time it is not the issue with the appliances per se. The issue is simply that good specialists are not buying into unsubstantiated gimmicks and prefer to stay away from the companies with dubious reputations.

Personally, I have my own collection of transferred cases that all had a specific type of brackets and looked alike: severe dental protrusion and a wrong bracket positioning facilitating a plaque accumulation. I know the brand has been heavily advertised in my area over the past few years. Among other claims, it was proposed that extractions is a mean of the past (the claim used for over a century), and that the extra-wide wires are a revolutionary orthodontic technology. As with most revolutions, they are done by the hands of an uneducated mob and cause a terrible mess…

I find it ironic how an obtrusive propaganda from the manufacturers inadvertently leads to a stigma around, at times, rather useful appliances. Isn’t it a good old story of the fisherman’s wife who was so insatiable with her greed that finally has been left with nothing but her old, dirty hovel?

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