The images show the smiles of two young men.

Both are thirty-two years old. Both are from educated, middle-class backgrounds. Both have responsible jobs working in the city. Both grew up in London.

Young man smiles: Patient A
Young man smiles: Patient A

These two young men also have ‘healthy’ teeth: no cavities, no fillings and certainly no missing teeth. Their dental hygiene is good, although one is better than the other.

So what is the difference?

Well it is obvious.

Straighter White Teeth

Whether it is ‘naturally so’ or  after orthodontic straightening, one of them has beautiful straight teeth (patient A). The other one does not have straight teeth (patient B). Yet he did have orthodontic treatment as a teenager.

Young man smiles: patient B
Young man smiles: patient B

Was it totally successful? Perhaps not.

Why is there such a difference?

It’s not an individual’s fault if they develop crooked teeth … that can be largely genetic. So often, people do go through a course of orthodontics  (braces etc.) to achieve the really attractive, straight beautiful smile. But no one should have to go through it more than once in a lifetime.

So what could have gone wrong? These are possible explanations:

  • The orthodontist wasn’t really that competent and the treatment was ‘sloppy’.
  • Proper permanent retention was not fitted, so the teeth drifted back.
  • The patient did not complete the course of treatment .

Was patient B happy with his teeth?

Was he aware that they could have been straight; that he could, in fact, have looked like patient A?

Did he ask any of his previous dentists?

Did any of the previous London dentists he went to even in the last ten years mention anything to him.

Did any of them suggest that this could be corrected? (Actually, they did not).

For Patient B) to correct his teeth and look more like patient A), he will have to go through another course of Orthodontics. Albeit, perhaps a more ‘limited’ one. In fact a  modern technique such as ‘Six Month Smiles’  may well fix the problem, indeed in just a few months (much less than the traditional  1 ½ years with ‘full orthodontics’) ….. as it is limited to just the front of the mouth.

Will he have this done?

I don’t know as I only saw him this morning. Why would he or why would he not? At this stage these are rhetorical questions.

It isn’t just about aesthetics: the staining, the gap: the misalignment and the crookedness. Straight teeth really are much easier to keep clean (not the staining he has). Nevertheless, ‘aesthetics’ is a matter of personal opinion. There is not a right or wrong … it is all about perception, expectation and projected image. However, if you were interviewing these guys for a job or you were thinking of dating them, which would you choose?

It really is pretty predictable that Patient B would prefer to have the dental appearance and smile of Patient A. Is he really going to be ‘interested’ in knowing what his treatment options are? Will he be prepared to go to the time expense and bother to achieve this (in the ‘right way… with orthodontics)?

Perhaps what is really important here is that orthodontics should achieve straight teeth in the first place and they should be kept stable over time.

All dentists in the City should offer patients the opportunity and choices of not just treating disease but correcting crooked teeth, without necessarily waiting for a patient ‘to ask’.

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