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 Table of Contents  
Year : 2016  |  Volume : 50  |  Issue : 4  |  Page : 205-206

Of smiles and souls

Prof. and HOD, Department of Orthodontics, SRMC, Porur, Chennai, Tamil Nadu, India

Date of Submission06-Oct-2016
Date of Acceptance08-Oct-2016
Date of Web Publication19-Oct-2016

Correspondence Address:
Sridevi Padmanabhan
Department of Orthodontics, SRMC, Porur, Chennai, Tamil Nadu
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/0301-5742.192621

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How to cite this article:
Padmanabhan S. Of smiles and souls. J Indian Orthod Soc 2016;50:205-6

How to cite this URL:
Padmanabhan S. Of smiles and souls. J Indian Orthod Soc [serial online] 2016 [cited 2019 Jun 16];50:205-6. Available from: http://www.jios.in/text.asp?2016/50/4/205/192621

It is that time of the year again when the IOS celebrates Orthodontist's day on October 5. When several study groups and institutions mark the occasion with various programs to increase awareness amidst the public and professional colleagues, it might augur well to take a minute to evaluate where we as a profession are going and the statement we make along the way.

The image of dentistry and orthodontics in particular is perceived as predominantly cosmetic and while the emphasis on enhanced esthetics cannot be discounted, with all the other challenges that we face, the aggressive marketing that is prevalent nowadays sometimes even offering potential clients a “bridal dental makeover” and similar others is rather disquieting. One wonders whether the art and science of Orthodontics is edging more toward the beauty industry.

This brings to mind an article entitled, “Orthodontics justified as a profession.”[1] The authors point out that the recipients of our services do not suffer from mortality and morbidity and since orthodontists do not treat disease like caries and periodontal disease, should they be called clients instead of patients? Abundant research has shown that Orthodontics enhances not merely esthetics but also psychological health. Orthodontics has positive effects on function, periodontal status, and oral health, and in recent years, the influence of teeth and jaws on the airway has evinced enormous interest. While the relation between occlusion and temporomandibular joint has always been the subject of debate, the Times of India recently highlighted research which showed that body balance was significantly affected by occlusion and suggested that stable occlusion improves postural balance particularly in unstable conditions and fatigue.[2] While previous research has also explored the connection between occlusion and postural balance, we recently found that postural balance becomes progressively worse with severity of malocclusion.[3]

In recent times, it has been acknowledged that traditional measures of treatment outcome are of little relevance to the patient and “real life” outcome measures are important and the term quality of life (QOL) has become popular in medical literature.[4] The true impact of health and disease on QOL is known as health-related quality of life (HRQL), and this has been widely acknowledged in medicine although its importance in oral health has been noted only in the last 10–15 years.[5] This becomes particularly important, especially in those interventions which are deemed cosmetic or elective.

It is considered that HRQL measures are difficult to apply in Orthodontics because most variations are treated with reference to an arbitrary norm. Moreover, most measures developed in dentistry do not apply since most orthodontic measures are asymptomatic and are related to esthetic concerns.[6]

Despite this, a search of literature reveals significant research on this topic, showing that there is a paradigm shift from the limited physical focus on malocclusion to the overall focus on the patient. A recent systematic review found that there is a modest association between orthodontic treatment and QOL.[7] Oral HRQL scores deteriorated in the 1st month of treatment and significantly improved after the appliance was debonded. Patients treated with orthodontics showed significant improvement over untreated controls.

Rinchuse and Rinchuse submit that orthodontics is justified as a profession saying that orthodontic treatment affects not only the traditional Jackson Triad but also the triad of the spirit, mind, and body.[1] Perhaps the influence of the orthodontic profession on overall patient well-being can be best expressed by the words of Jean Cocteau.

If there is a defect on the soul, it cannot be corrected on the face;


if there is a defect on the face and one corrects it,

it can correct a soul!”

  References Top

Rinchuse DJ, Rinchuse DJ. Orthodontics justified as a profession. Am J Orthod Dentofacial Orthop 2002;121:93-6.  Back to cited text no. 1
Julià-Sánchez S, Álvarez-Herms J, Gatterer H, Burtscher M, Pagès T, Viscor G. The influence of dental occlusion on the body balance in unstable platform increases after high intensity exercise. Neurosci Lett 2016;617:116-21.  Back to cited text no. 2
Arumugam P, Padmanabhan S, Chitharanjan AB. The relationship of postural body stability and severity of malocclusion. APOS Trends Orthod 2016;6:205-10.  Back to cited text no. 3
  Medknow Journal  
Dijkers M. Measuring quality of life: Methodological issues. Am J Phys Med Rehabil 1999;78:286-300.  Back to cited text no. 4
Cunningham SJ, Hunt NP. Quality of life and its importance in orthodontics. J Orthod 2001;28:152-8.  Back to cited text no. 5
O'Brien K, Kay L, Fox D, Mandall N. Assessing oral health outcomes for orthodontics – Measuring health status and quality of life. Community Dent Health 1998;15:22-6.  Back to cited text no. 6
Zhou Y, Wang Y, Wang X, Volière G, Hu R. The impact of orthodontic treatment on the quality of life a systematic review. BMC Oral Health 2014;14:66.  Back to cited text no. 7


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