You will witness two peculiar subjects being discussed in this article. One, the highly controversial conduct of interceptive orthodontics for kids with mixed dentition, and two, the even more disputed practice of promoting clear aligner treatment in young children.
But first, let’s take a look at what interceptive orthodontics encompasses. Defining this in simple terms would look something like this; “to intercept something” is the act of obstructing or preventing something from happening. Interceptive orthodontics, or more conveniently named preventative orthodontics adheres to the same principle.
Orthodontists use early orthodontic interventions to identify potential malocclusion issues in the developing dentition and suppress or correct any of these unfavorable changes. By intercepting early on when the child’s bite has not completely developed yet, they can successfully eliminate or reduce the severity of bite issues down the line.
While all that is good and dandy, using clear aligners to correct children’s bite issues has been a subject of great contention. This study gives us an insight into the effectiveness of clear aligner treatment for children presenting with mixed dentition.
This 2023 study originates from a team of six researchers from the Department of Orthodontics of Virginia Commonwealth University in the United States. The American Journal of Orthodontics & Dentofacial Orthopedics (AJO-DDO) published this paper.
by Nicholas M. Lynch, Bhavna Shroff, Caroline K. Carrico, Vincent Sawicki, Morgan Sabol, Steven J. Lindauer
AJO-DDO. 2023; https://doi.org/10.1016/j.ajodo.2022.11.018
Objective of the study
Studies suggest that the jaw bones of children between the ages of 4 and 11 are actively in the growing phase, therefore, pediatric orthodontists believe that by correcting their occlusion at this stage, they can significantly reduce the complexity of orthodontic treatment in the future while also cutting down treatment time and cost.
The authors of this study embarked on this journey to prove or refute this hypothesis.
They listed the objective of this study as:
“To evaluate current trends and perspectives among orthodontists regarding clear aligner therapy in the mixed dentition (CAMD), including insights into perceived indications, compliance, oral hygiene, and other factors.”
Materials and methods
They carried out a cross-sectional survey of orthodontists by using a 22-item survey.
The survey was mailed to:
This sample pool was identified from the AAO online data or Align Technologies Invisalign provider website. They sent out the first survey and six weeks later followed up with a repeat mail.
Results
Out of the 1000 orthodontists that were surveyed, 181 responded to the survey over 12 weeks. The resulting response rate was 18.1%.
The results of this survey revealed a few interesting things:
Outcomes
CAMD was found to be much less used as compared to fixed appliances for mixed dentition. However, respondents predicted an increase in their future CAMD.
Most respondents expressed that CAMD was less useful than fixed appliances for growth modification, skeletal expansion, and habit cessation.
Final thoughts
This paper was fully derived from the real-life experiences of practitioners. Due to this, we believe that this study was monumental in the sense that it described what works in the practical world and what does not.
Most orthodontists reportedly did not use CAMD for all forms of interceptive treatment but did use them for simple occlusion problems. This gives us an insight into the ironic popularity/disfavor dynamic of clear aligner use in treating children’s malalignment.
However, since the response rate collected in this study was low, we can only hope that more dentists make use of CAMD over fixed braces. Nevertheless, more research needs to be done on the effectiveness of clear aligners in mixed dentition.