Claims about orthodontics

The role of the British Orthodontic Society (BOS) is to promote the highest quality standard of care throughout the UK. This statement has been compiled by the BOS to help navigate some of the claims that are made about orthodontics, so you can find the best treatment for you or your child. More general information can be found elsewhere on the BOS website.

Orthodontics is very popular in the UK. Around 200,000 young people undergo NHS-funded orthodontic treatment annually and there is an increase in the number of adults choosing to have private treatment.

Extraction-based treatment

Sometimes, in an overcrowded mouth, it is impossible to accommodate all the teeth in the upper and lower dental arches in the best position. Therefore, your orthodontist may need to extract some teeth in order to achieve the best possible result. Extractions are never undertaken lightly and extensive planning and experience will go into making that decision. When they are recommended, it’s because they are in the best interests of the patient and necessary for a good result to be obtained.

The NHS Business Services Authority, the organisation which monitors dental activity in NHS primary care, says that around 25% of young people have extractions prior to wearing fixed braces. In appropriate cases, treatments involving extractions increase the chances of a stable result in the long term.

It may be possible, when there is crowding, to avoid extractions. For example, it is sometimes possible to create space to relieve crowding by expanding the dental arches to accommodate the teeth. However, this is not always feasible and is not always the best approach. It is also possible to remove a very thin sliver of enamel from the sides of the teeth to create some space, but this is not possible or effective for all patients, particularly if there is a lot of crowding. Because we are all individuals, there is no advice or guidance that will apply to all patients. An assessment undertaken by an orthodontist or a dentist with orthodontic training, is essential to know what is most appropriate.

Misleading claims

As a result of increased marketing, many claims are made about brace-wearing. During the last two years the Advertising Standards Authority has upheld cases where websites were making unsubstantiated claims about orthodontic treatment. The BOS has made a video to help patients embarking on treatment to make the right choices (https://www.bos.org.uk/Public-Patients/Orthodontics-for-Adults/Orthodontics-making-the-right-choices-for-you)

The BOS advocates that you proceed with caution if you are told that a recommended orthodontic treatment or approach will do any of the following:

• Cause your child’s cheek bones to rise or their jaws to change significantly in position – such changes may occur naturally as part of a child’s development but are not achieved as part of orthodontic treatment
• Cure or cause jaw joint problems – there is no evidence for
• Improve speech– there is no evidence for this
• Improve breathing – there is no evidence for this

Your clinician should explain to you why they are recommending a particular approach and highlight any associated risks. In such instances, if there is any doubt in your mind, a second, independent opinion can provide the perspective that is needed. Your clinician should support you in securing a second opinion so that you can be sure you are choosing the best treatment for your needs.

In summary:

• In some patients, extractions are the only way to achieve a good long-term result
• Be wary of exaggerated claims about orthodontic
• There is no guidance that can apply to all patient
• If in doubt, seek a second opinion

We are grateful to the following for their input: Professors Philip Benson and Susan Cunningham, Drs Padhraig Fleming, Chris Kettler, Richard George, Brian Kelly and Nigel Harradine and the British Orthodontic Society’s patient panel.