As an orthodontic provider, you often have to weigh your patients’ personal requests with what you know is the most appropriate form of treatment. This is especially true in the situation that an individual asks for rapid “fast” braces, or single-arch orthodontics where appliances are only affixed to the upper teeth.
For Problem Specific Tooth Movement
Many orthodontic patients request single-arch treatment because they only want braces on their top front teeth. They feel this may be more comfortable, affordable, and faster.
In instances where minor tooth movement is all that is necessary, this alternative may be appropriate. For example, a mild diastema between the central incisors can be closed, which also reduces slight overbites. Assuming that the patient will be content with the aesthetic results (and the provider with the occlusal relationships,) this type of alternative treatment may be a viable option.
Mild crowding, tooth overlap, or orthodontic relapse may also be adequately treated with single arch ortho on a case-by-case basis.
Younger patients who are undergoing “phase 1” or interceptive treatments are some of the most common individuals to need single arch treatment. This is usually due to the physical maturation of the oral anatomy, tooth development, or eruptive stages. In such instances, single arch therapies can make it more effective to lay the groundwork for more complex comprehensive phase 2 treatments later on.
Determining “if single arch treatment is right” or not may be a simple decision, solely due to the patient’s oral anatomy.
When Single-Arch Braces Should be Ruled Out
There is only so much that can be done with overall tooth alignment if the upper and lower teeth do not occlude properly. Single-arch treatment could result in an open bite, cross bite, or fail to correct an overbite if the patient refuses to have braces placed on the opposite arch. Over time, this might contribute to occlusal wear, fractured dental work, or TMJD.
It’s easy for a dental expert to understand this, but a patient may not. A good analogy is comparing single arch treatment to screwing the lid onto a jar, by only holding the lid. The final fit wouldn’t be what it could have if you had a “grip” on both the jar and lid, as it would if you had braces on both the upper and lower arches at the same time.
Discuss the Patient’s Concern for Getting “Only Single Arch” Treatment
Many patients assume that asking their orthodontist to “only put braces on their top teeth” will result in a 50% reduction in the overall cost of their orthodontic therapy. As a dental professional, you know otherwise.
If a patient is hesitant to accept a comprehensive orthodontic treatment plan, find out if they have any questions or need to understand aspects of the plan better. Offer financing information up front, as some individuals may be too embarrassed to ask, and thus appear to be close minded about starting treatment.
Should the conversation turn the direction of “getting braces on one arch will be much cheaper,” redirect the discussion to conclude that there is not a significant price difference between comprehensive (upper/lower arch) and single-arch therapy, and why. This information should be presented in any situation that a patient requests single arch treatment.
“Superelastic” Archwires and Clear Aligners
Modern orthodontic brands are beginning to target this market with specially designed systems that use force optimized biomechanics for a single-arch-only treatment. If attachments, rubber bands, TADs, or other extensions aren’t primarily mandatory for the given situation, a clear aligner or superplastic archwire system may do the job.
Additional Analysis to Make the Final Call
With digital cephalometric analysis performed by radiographic experts like the team at CephX, AlgoCeph technology makes it possible to plan the most accurate and efficient orthodontic case for your patient. In instances such as single arch treatment where you may want a second opinion, the AlgoCeph reading can be performed in an efficient timeframe without referring your patient elsewhere or lowering your productivity.
Determining Your Options
One of the foundations of treatment planning and case presentation is presenting your patient with all viable options to treat their concerns, and weigh the advantages of each. For orthodontic providers who tend to have a bias against single arch ortho cases, it can be difficult to encourage the patient to accept a care plan when this option is overlooked.
Knowing that the patient will decline any therapies aside from one-arch braces should be weighed against whether or not the therapy would be doing harm over good. Sure, it may not be the most preferred method of treatment — especially if you were planning the course of therapy for yourself or your own child — but if that is all the patient is willing to consider, this must be kept in mind.
Is it Time to Think Outside of the Box?
In dentistry, technology and treatments can change significantly from one decade to the next. What we’re taught in school may be completely obsolete once a few years have passed and new studies back findings in more recent clinical research studies. When it comes to single arch treatment, it’s vital to go into the planning process with an open mind. Given the case-by-case nature of patients in general, there will be exceptions that are worth your consideration.
If you’re new to single-arch therapies, aim to work with fellow specialists who can help you treatment plan the case during the initial diagnosis and assessment phases; that way you can ensure a positive outcome from the beginning of therapy.
Orthodontic Specialists Consider all of the Options
At CephX, our x-ray analysis experts can efficiently measure and assess the digital images of your patient’s radiographs, so that you have all of the information on hand during your case presentation. This saves you valuable time without risking the quality of care your office provides. The cephalometric analysis is available on demand, and all records are securely backed up at the highest level of privacy. Visit www.CephX.com today to learn more about on-demand orthodontic cephalometric analysis for providers on a worldwide scale.