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Orthodontics/Acceledent on Regular Braces?

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Question
Hello Paul,
I am getting braces in 2 weeks. I was notified that with the use of this new technology called Acceledent the time with the braces will be reduced to 15 months, opposed to 30. However, I looked up on the forums about Acceledent and it only popped up in Invisalign forums. Is Acceledent actually effective on normal braces as well?

Best regards,
Joseph

Answer
Hi Joseph,

I see you posed this question a few days ago ( Dec. 1, 2014) and for whatever reason I am not getting the notifications that I have questions pending. Pardon the delay.

You have brought up an interesting question, and it actually reflects on an even broader issue, namely what is the lay person to make of all these claims by dental manufacturers. Can the advertisements and many claims be believed? What about the "Doctor" in the white clinical coat who swears up and down that medication X, or procedure Y, or exercise regime Z has produced astounding results and a cure for this or that.

Joseph, you are absolutely right to maintain a critical perspective. Moreover, many of the guys in the white coats are very well compensated to lecture on behalf of Company X, Y, or Z. If you have the background and determination, even as a lay person, the best thing to do is to examine the principles of Evidence Based Medicine and Evidence Based Dentistry.  Here is a link to the website of the American Dental Association where there is an overview of Evidence Based Dentistry.

http://ebd.ada.org/en/

At a recent Annual Session of the American Association of Orthodontists I went to a lecture where various new treatment modalities were being discussed. One method which involved small perforations into the bone surrounding the roots seemed to have been fairly well received by clinicians. The acceledent system, as I best recall, did not generate that sort of enthusiasm. That is not to say that acceledent does not work, but regardless of what supposed enhanced treatment strategy you use, it behooves you to critically examine the clinical evidence before accepting the many claims of faster treatment results.

Again, Evidence Based Dentistry should be able to reveal whether such claims are grounded or not. The noble claim that the 30 month treatment time will be reduced to 15 months sounds wonderful. Can it be believed? It is often difficult to determine just how long treatment will take. The time needed can vary greatly, and until treatment begins and the clinician can get a handle on how well the teeth are moving and how nicely particular problems such as a cross-bite or an impacted tooth are resolving, to formulate precise treatment time claims ( and reductions ) is in my opinion somewhat meaningless.

The bottom line for you Joseph is to continue to ask questions. If you have doubts and concerns, then:

1)  Ask the Doctor to provide you with copies of your records and go get a 2nd or 3rd opinion.
2)  If you are within driving distance of a University that has a dental school with an Orthodontic Graduate Program, see if you can request a consultation.
3)  Ask the original doctor what makes him/her comfortable stating that the treatment time will be cut in half. Remember the Evidence Based Pyramid? The very bottom rung of the ladder is the so called " Expert Opinion ", in contrast to say a meta-analysis.

Finally, if your treatment time was quoted at 30 months, then perhaps this is an over estimate, or perhaps you truly have a very complex set of clinical issues, and the so called 15 month estimate may be an under-estimate. I can say with confidence that the acceledent system is a relatively recent development, and a large epidemiological database of clinical studies and treatment outcome information has not yet been developed. There is no shortage of Orthodontists in the US from which to choose. Why not get a second opinion from clinicians who can have a chance to actually look at your teeth and to examine the clinical records including any appropriate x-rays. Otherwise, you can always just default to the traditional approach with your first doctor, and see if he/she can try to complete the treatment as best possible in under 30 months.

Good luck Joseph, and thank you for a very thought provoking question.

Paul Supan, DDS, MA, MPH
Board Certified Orthodontist

Specialist in Orthodontics
Specialist in Dental Public Health
http://www.braces.com
http://www.leesburgbraces.com  

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Paul Supan, DDS, MA, MPH

Expertise

First may I say please set your questions to Public so other readers can benefit from the response. Also, if you look at my comprehensive answers, they are not short 1 or 2 paragraph quickie replies that anyone can type out in < 5 minutes. Instead I often will ask other colleagues in other specialties for their advice in order to provide you the questioner with a more interdisciplinary perspective. This all takes time. I ask for readers to therefore allow 5-7 days. You will be rewarded with a very detailed response.

Because of the nature of Orthodontic questions, any pictures of the teeth and X-ray images would be very helpful. If you write to me and explain that you have crooked overlapping front teeth can be interpreted in many many ways, and my goal is to provide a specific response that meets your needs.

I hold double specialty credentials. I am Board Certified in Orthodontics and Board Eligible in Dental Public Health. I welcome questions regarding Braces, Invisible Braces, & Invisalign, as well as issues involving combination Cosmetic Dentistry and Orthodontic treatment. Orthodontics alone sometimes is not enough to achieve that perfect smile. Gingival (gum) re-contouring, tooth reshaping, bonding and other services are sometimes needed. I also have substantial experience in the areas of Infection Control and Sterilization in the Dental Environment. My personal websites braces.com and Leesburgbraces.com are non-commercial for information purposes only and may provide you with some background to more precisely frame your question for allexperts.com.

Please allow a week for a reply. I am in full time Private Practice, lecture on occasion, and am involved in many volunteer activities. I am therefore not always able to respond to questions straight away. Your understanding is appreciated.

Experience

Board Certified Orthodontist (ABO Diplomate) with over 25 years of Private Practice experience. Second Specialty Certificate in Dental Public Health with research experience at NIH, and Epidemiology Training & Research at Harvard, NIH, and the Centers for Disease Control (CDC) in Atlanta. Postgraduate Masters degree from the Harvard School of Public Health, as well as a Master of Arts Degree in Education.

Organizations
American Dental Association, American Association of Orthodontists, Academy of General Dentistry, College of Diplomates of the ABO, OSAP - Office Sterilization & Asepsis Procedures Organization, Others

Publications
Available upon Request.

Education/Credentials
BS College of William & Mary, DDS Medical College of Virginia, Masters of Public Health (MPH) Degree Harvard School of Public Health. Dental Public Health Specialty Certificate from NIH. Orthodontic Specialty Certificate from University of Rochester Eastman Dental Center. USPHS clinical research experience at NIH, and Epidemiology Training & Research at Harvard, NIH, and the Centers for Disease Control. Fellow of the Academy of General Dentistry (FAGD), and Fully Board Certified Diplomate of the American Board of Orthodontics. Board Eligible in Dental Public Health. Visiting Adjunct Associate Professor at the Meharry Medical College School of Dentistry, Nashville, Tennessee.

Awards and Honors
Available upon Request Please see my personal websites braces.com and Leesburgbraces.com for further personal background.

Past/Present Clients
Available upon Request

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