Here you will find everything related to cephalometric analysis, digital radiography, Dental imaging basically everything ceph-related.

Digital Dentistry: How it Increases Patient Quality of Care

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In the past decade alone, the dental industry has witnessed a revolution from within. From two-dimensional diagnostics to high-definition 3D dentistry that’s analyzed by specialists at remote partner sites, our patients are deserving of the most advanced oral health care now more than ever before.

Visualizing the Experience for a Higher Case Acceptance Rate

Seeing is believing. Digital dentistry means giving patients the ability to view their oral health needs on monitors to “self-diagnose” problems like decay, impacted teeth, or bone loss, without having a degree in dentistry. As you guide individuals through the visualization of their x-rays and intraoral photography, it’s hard to deny what they can see for themselves.

Some offices even implement a “before and after” makeover system where patients can see what their portrait looks like after undergoing various proposed treatments, such as braces, veneers, clear aligners, or teeth whitening. When placed adjacent to their “before” photo, your patient can visualize what their investment can deliver once the treatment is completed.

Enhanced Quality for Predictable Outcomes

Remember when CAD/CAM dentistry became available? Without any gooey impressions or gagging on your patients’ part, you could take an extremely accurate digital impression of a prepped tooth with no fear of materials warping, bubbling, or cracking. The virtual scanning systems used for stand-alone in-house ceramic crowns are now used for everything from multi-unit bridges to orthodontic impressions. Even if you’re still using an off-site lab to create a restorative or orthodontic prosthesis, you can save valuable time by avoiding the transportation and processing of a conventional impression.

Without the fear of or room for human error, digitized dental equipment means fewer re-appointments, no re-impressions, and a faster, accurate delivery of your fixed or removable appliance.

Highly Efficient Procedures Reduce Treatment Time

Conebeam imaging is just one example of how patients now have access to faster, better treatment. Dentists can now place dental implants using computer guided technology, when these patients would have previously been told that they would never be a candidate due to unique or specific anatomical bone needs. Digital dentistry changes the lives of the patients being cared for.

This same 3D imaging allows technologies used for orthodontic treatment planning and diagnosis to pinpoint unique tooth movements and create a virtual mock-up of the overall treatment experience before therapy even starts. Due to the omission of human error in treatment planning and diagnosis, orthodontists can assure that they’ve empowered their patients with the very best possible outcome (assuming patients are compliant in all areas with their treatment plan!)

Access to Professional Support Outlets

At CephX, we understand better than anyone how digital dentistry brings professionals together to collaborate in the patient care experience. As you may know, we offer cephalometric X-ray analysis through AlgoCeph technology so that orthodontists and orthodontic providers can have their patients’ images analyzed, marked, and returned back to the practitioner in an extremely short period of time. This frees the orthodontist up from having to tediously mark up the cephalometric images for each patient, without compromising their quality of services or spending less time with their patients.

Opening Teledentistry Opportunities Free of Geographical Barriers

Teledentistry is quickly gaining ground when it comes to bringing patients in touch with dentists and specialists like orthodontic providers. Now, people can snap a photo or even take an impression of their teeth to start the consultation process for handling a dental emergency or even begin an orthodontic treatment. While these may not always be the choice method of starting patient treatment, they dissolve geographical barriers or even financial hindrances when it comes to individuals and their families getting access to the oral health services that they need.

In fact, teledentistry is such a big thing now, that dental boards are adopting appropriate legislative steps to ensure that both patients and providers are protected. This means that patients can only receive “care” or consultations with licensed dentists, without having to fear that the person on the other end of the wire is putting on a false front.

Less Space to Safely Store Patient Records.

HIPAA compliant cloud-based data storage means that dentists and orthodontists can save their patient files securely on the world wide web. As such, multi-location practices can access charts at any time, without having to transfer records or worrying about losing a paper file.

Small practice owners can free up space in storage or their reception area, as no physical areas need to be set aside to store patient files.

Programs like CephX’s AlgoCeph system mean that orthodontists can even access their patients’ records from mobile devices and iPads in or out of the practice. Everything is securely backed-up and secured, so that 3rd party access isn’t a concern. Yet it’s available at an instant, so that you never have to worry about misplacing or losing a file during your patient consultations.

Virtual Treatments With Data Read-Outs for Enhanced Accuracy

With the touch of a button, dentists and specialists can now see real-time analysis during clinical procedures (such as root canal therapy) on a monitor adjacent to their patient. From analyzing the pressure involved to performing accurate measurements in and around the teeth, dentists can know they’re providing extremely meticulous restorative work in every situation that they find themselves in.

Changing Everyday Dental Care in Your Practice

At CephX, digital dentistry has transformed the way our radiographic and orthodontic experts work with orthodontists and general practitioners worldwide. When you see patients for an orthodontic consult and record a cephalometric film, you can use our secure, cloud-based system to have the image thoroughly screened and analyzed in just a matter of seconds. That way you can spend more time talking with your patients, answering questions, and less time away from the chair.

What’s preventing you from providing the very best in orthodontic care to your patients? Do you need the assurance of working with a team of orthodontists and analysts to provide greater efficiency and productivity in your practice? Digital dentistry may be the solution. We invite you to contact CephX today to learn more about our AlgoCeph technology and cloud resources for the independent and multi-group practice.

Read more about Retainers and Maintenance: Preserving Your Patients’ Investment
and Case study – Dr. Ivan Goryalov

Increasing Case Acceptance in Adult Orthodontic Patients

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Most dentists and orthodontists are seeing a tremendous increase in the number of adult patients they’re seeing for orthodontic therapy. While there are a variety of reasons for this, many of them are related to the fact that today’s adults didn’t have access to getting braces as children. There’s also a greater appreciation for the health and alignment of the teeth, and how those characteristics affect someone’s personal, private, and professional life.

Unfortunately, getting patients through the front door to schedule an orthodontic consultation is only half of the battle. The other half involves finding a treatment plan that meets the physical and emotional needs of adult patients and getting them to move forward with treatment.

Aesthetic Considerations Need to be Addressed

Which type(s) of braces you offer may impact whether or not your adult patient wants to move forward with treatment. For some, a traditional alignment system is not of much concern. Or, ceramic brackets are adequate to ease the worries about what it looks like to wear braces as an adult. Even still, clear alignment tray systems can completely eliminate this barrier when it comes to moving forward with treatment.

We recommend offering at least two to three different options to your adult patients, allowing them to review the benefits of each. As you guide them through your recommendations, they can judge whether or not the aesthetic aspect of their appearance during treatment outweighs other concerns (such as cost and time.) They may not even realize that it is a concern, until you point out other alternatives that may be available.

Time Constraints for Busy Professionals and Parents

Time away from one’s professional and personal commitments may be a deciding factor in moving forward with orthodontic treatment. Although this is something that an orthodontic provider has little control over, there are steps to ease the inconvenience for your patients.

For instance, your practice may want to:

  • Explain that certain types of treatments generally do not require as many or as long of appointments as other types of therapies. Include this benefit during the explanation of the options that are available. Take care to not draw too many negatives into your discussion, but highlight the positives that certain forms of adult treatments bring to the patient’s benefit. For example, mentioning “Because these aligners are removable and computer generated, your follow up appointments will typically be much shorter and easier to work into your lunch break or on your commute home from work.”
  • Provide alternatives, such as “cosmetic” or “fast” braces systems that treat aesthetic misalignment in a shorter period of time. Again, take note to not point out negatives with any of the treatments that you offer, but instead offer an alternative if it appears your patient is hesitant to commit the next 12 months to wearing orthodontics.
  • Make special accommodations in your office schedule for your adult patients. Perhaps this means coming in early at 7am on Friday mornings, or staying late one night a week, so that adults can book their visits before or after work. The simpler you make the scheduling process, the fewer excuses an adult has in finally enjoying a straighter smile.

Making Assumptions About the Price

One of the final straws in accepting a recommended care plan is the cost of the treatments. That’s why we recommend automatically including a financing program as part of your case presentation. Occasionally you may get someone who says “Never mind that, I prefer to pay for it all up front,” but this usually will not be the case.

Regarding your financing plan, try to offer at least two different options. Perhaps one has a larger down payment and smaller monthly fee, while the other is no down payment with a fixed monthly fee for a set period of time. If it’s interest free, it’s even better!

You never know what a person’s financial status is. They may appear to be well off, but struggling to make it between paychecks. Or, they may seem to have a fairly modest lifestyle, but have plenty of extra funds tucked away as they’ve been saving up for treatment. Leave that decision up to them without making anyone feel embarrassed. By presenting at least two forms of payment options, you can help to reduce the financial burden of moving forward with what may seem like an elective treatment.

Never make someone feel as if they can’t pay for something, but do be proud of your fee schedule. Your fees reflect your quality of care and dedication to patients. Just be sure to provide an avenue to make it financially attainable for the population in your practice area.

Giving Virtual Data Aids in Treatment Plan Acceptance

Finally, some people need to see things for themselves before deciding that a particular treatment is right for them. When you make patients an active part of co-planning and co-diagnosis, they feel more responsible for choosing the type of treatment to correct their needs. One of the best ways to do this is to implement high-definition imaging technology into your operatories and consultation rooms.

Bringing the photographs, X-rays, and diagnostic imaging onto the screen allows your adult patients to see what it is that you’re talking about, as you explain how things came to be, or can be changed. The old saying “A picture is worth 1,000 words” has never been truer than when you’re explaining dental procedures and orthodontic therapy to your patients.

At CephX, we take orthodontic and digital imaging to the next level. Orthodontic providers (specialists and general practitioners alike) can save time through our professional ceph exams, measurements, classifications, and insights. That way you have more time to spend talking to patients and closing the “sale” of having them move forward with treatment. Plus, all our records are fully secured on the cloud and backed-up to save you valuable storage space.

To learn more about our mobile-friendly AlgoCeph technology, contact CephX for a complimentary consultation with one of our orthodontic imaging and diagnostic experts.

Read more about Case study – Dr. Ivan Goryalov
and Orthodontic Treatment Plan

Common Psychological Aspects of Orthodontic Treatment -The Child, Adolescent and Adult Patient

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As we all know, orthodontics is a long-term partnership. Psychological factors influence the choice of an orthodontist. Aside from protracted full mouth rehabilitation, most general and specialty dental procedures are done “to” the patient in a brief time and “as needed” rather than “with” the patient over a span of years.

This is not to say that non-orthodontic dental patients do not establish long term relationships with their dentists. Orthodontic-patient relationships necessarily have certain “dental” commonalities with non-orthodontic-patient relationships, but the difference lies mostly in long term related objectives with a resulting set of unique patient-practitioner psychological mindsets.

Basic Orthodontic Patient Psychology

Although it probably seems obvious to the average layman, numerous scientific studies have been undertaken that do confirm poor facial esthetics is related to:

  • Low self-esteem.
  • Problematic social activities/interactions.
  • Adverse occupational outcomes.

That being true, it is not at all hard to appreciate that the main reason for the majority of orthodontic patients and parents to seek orthodontic treatment regardless of age is found to be the attainment (or improvement) of an attractive dental-facial relationship.

Basic motivational factors are influenced by:

  • Social Environment.
  • Gender
  • Economic status
  • Behavioral traits
  • Personal issues

Basic motivational factors are influenced by:

Unless severe, functional issues of malocclusion having possible deleterious dental consequences often go unnoticed by individuals or parents. Even when apprised of functional issues, many patients or parents may not typically consider them enough of a key motivating factor(s) for the time and expense of undergoing treatment.

The Adult Patient

In the not so distant past, orthodontic treatment for adults was somewhat of a rarity.

Some of the past psychological and societal barriers to adult treatment included:

  • “Braces are only for kids and teenagers”
  • Occupational considerations
  • Affordability
  • Considered a “vanity”
  • Appearance of metal braces

In contrast, it is estimated today that 1 in 5 patients in a typical orthodontic practice are adults with some practices reporting an adult patient level nearing 50 percent.

The advent of lingual braces and “invisible” dental aligners along with changing societal norms have allowed adults to overcome some of the psychological and societal prohibitions of appearing in public as an adult with a “full metal jacket” of traditional “old school” braces.

The Adolescent Patient

Adolescent psychology has long been a subject of interest to orthodontists. Like parents, it comes as somewhat of a surprise to them to see a relatively happy “well-adjusted” child patient gradually morph into a “whatever” teenager.

Up until the past 20 or so years, a common general layman’s perception was that of teenagers fearing the prospect of hearing the dreaded parental phrase, “You need braces!”. Visions of metal mouth teenagers being teased by their peers was a daunting prospect to both patient and parent. And there was and still is some truth to those characterizations even with modern orthodontic innovations.

Thankfully, psychological and societal norms have changed and rather than being a social detriment, wearing braces as a teenager has become an accepted norm. In fact, it is known through numerous social psychology and health science studies that peer pressure, rather than being a psychological barrier because of teasing etc., has now become one of the most powerful incentives and motivational factors leading teenagers to seek orthodontic treatment. Wearing braces has gone from just a means for improving facial esthetics to a positive social incentive with the extra bonus of now being an “in” thing.

Technical improvements have also made orthodontic treatment more psychologically acceptable for adolescents with the innovation of teen version dental aligners, clear brackets and the elimination of metal bands. There is also a current trend to make wearing more visible braces a fashion or personal statement with the introduction of various colored rubber bands, different shaped colored brackets, etc.

The Child Patient

Typically, child patients take their motivation for orthodontic treatment from their parents although that is not to say that some children do express concerns about the “crookedness” of their teeth. In the clear majority of cases, the mother is the parent that takes the lead in seeking consultation and treatment.

As with teenagers, the social stigma of the past regarding the wearing of braces among younger children has greatly decreased. One significant difference with the child patient is that peer pressure although a factor, does not seem to be a prime motivating social factor to the same degree as it is in adolescent patients.

The availability of colorful rubber bands, different shaped brackets and themed accessories (Spiderman, Hello Kitty) such as retainer boxes, toothbrushes, etc., can make the orthodontic experience less intimidating.

Orthodontist Concerns

Obviously for the orthodontist, the treatment for adults, adolescents and children entails the same end goal; proper establishment of functional orthodontic aspects as well as dental-facial esthetics. A basic understanding and use of adjunctive psychological approaches can be brought into play by the orthodontist to make these goals easier for the patient and more productive for the practitioner especially in the case of reticent patients and/or their parents.

Internal vs External Motivators

External

  • Adult – perceived improved occupational opportunities, improved interpersonal relationships
  • Adolescent – peer pressure, parental pressure, perceived improved interpersonal relationships
  • Child – parental pressure.

Internal

  • Adult – increased self-esteem, personal goal achievement, more attractive appearance
  • Adolescent – social acceptance, self-actualization, more attractive appearance
  • Child – parental approval, “better’ smile.

With each age group and patient appointment, the orthodontist will have unique opportunities to establish and maintain solid partnerships and increase patient rapport. These opportunities come through a basic understanding, continued study and application of patient-practitioner interactive psychology.

A busy practitioner needs every opportunity to increase the amount of time they can spend with their patients. They also need to keep abreast of modern technologies. Manual cephalometric analysis is very time consuming and can be stressful. Cephx online cephalometric analysis makes available 50 generic and custom analyses that can be managed from any device. Psychologically speaking from the viewpoint of that same busy orthodontist, besides freeing up some extra time for patient communication, using the services of a dedicated and trusted online cephalometric analysis company can help to take away some of the stress related to manual analysis. Cephx makes available their exclusive “Algoceph” algorithm and provides Cloud storage for seamless record retrieval. Visit our main website at: Cephx

Read more about Comparison between 2D and 3D Cephalometric Analyses
and Are Clear Aligners Right for Your Patient?

History of Cephalometric Analysis – Using Our Heads

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Interest in measuring the human form and skull has been around for millennia. The history of cephalometric analysis stems from Egyptian and Greek attempts at human body measurement (anthropometrics).

The term cephalometric is sometimes confused with craniometric. The former refers to measurement of the skull. The latter refers to measurement of the head including the soft tissue be it living or dead.

History of Cephalometric Analysis/Pre-Roentgen

4000 (BC) Egyptians: Canon of Proportions was a mathematical system developed to give idealistic proportions to the human form. Artistic forms were generated using a grid system.

Evidence of attempts at orthodontics and tooth “bridging systems” using wires have been found among the human remains of ancient civilizations. The idea that modern day orthodontics may have originated thousands of years ago, is certainly intriguing. This remaining ancient physical evidence of attempts at orthodontics indicates that the dentition and facial appearance were as important then as they are today.

* Although not strictly related to cephalometric contributions, attempts down through time have been made to qualify and quantify the human form by type. *

  • (c.460-c.370) Hippocrates: described two body types.
    Habitus phithicus: Long thin body
    Habitus apoplecticus: Short thick body
  • (1921) Kretschmer:
    Pyknic: Fat and stocky
    Asthenic: Weak, small and thin
    Athletic: Muscular and large boned
  • (1954) Sheldon:
    Endomorph: tending toward body fat
    Mesomorph: tending toward musculature
    Ectomorph: tending toward undeveloped muscle
  • (1452-1519) DaVinci: Arguably the first to try and systematically measure the head.

  • (1528) Albrecht Durer: A treatise on cranial measurements was the first published work in which anthropometry was applied to aesthetics.
  • (1678-1761) Pierre Fouchard: Published the “Surgeon Dentist” in 1728. Some consider him to be the “inventor” of orthodontics. Some of the “less than modern” methods of straightening teeth included finger pressure, metal plates lashed to abutment teeth, extractions and the use of a surgical instrument of the time called “The Pelican”. This instrument was used to make large forceful lingual to buccal tipping movements. If possible, it would have been interesting to talk to some of his teenage patients!
  • (1722-1789) Petrus Camper: introduced the facial angle, facial line and horizontal plane.
  • (1847) Joachim LaFoulon: Coined the term
  • (1796-1860) Anders Retzius: Credited with introducing the terms orthognathic, prognostic and the cephalic index.

Kingsley and Farrar are credited with being the “Fathers of Orthodontics”. Both wrote definitive books on orthodontics during the late 1800s.

Edward Angle was a paramount figure in orthodontics. His work in the early part of the twentieth century remains an influence in present day orthodontics.

Roentgen Leads The Way

(1895) Roentgen discovered X-rays in 1895 and submitted the paper, “On a New kind of Rays, a Preliminary Communication”. The following year Koening and Walkhoff simultaneously made the first dental X-ray of a tooth.

(1922) AJ Pacini is credited with making the first standard lateral view radiograph in 1922.

(1922) Paul Simon (Germany) becomes the first to use planes and angles in the diagnosis of dental anomalies

(1922-1931) During this period, various researchers reported on the use of radiographs in the practice of orthodontics. These contributions included the discovery of new radiographic landmarks and various attempts to incorporate and improve methods of diagnostic measurement including attempts to obtain a standardized practical method for obtaining radiographs.

(1931) Holly Broadbent along with Todd Wingate (United States), H. Hofrath (Germany) simultaneously developed the cephalostat. Broadbent occupies a special place in the evolution of cephalometrics as many of his principles and ideas have been accepted practice since their inception. Broadbent used a metric scale and reproducible head positioning of the cephalostat to eliminate the problems associated with previous unstandardized radiographic analysis.

(1937-1947) Much of the evolution of cephalometric analysis during this period was associated with investigating the craniofacial growth factors affecting orthodontic treatment (down and forward, Brodie 1941) and other factors relating to the dentation in its relationship to various craniofacial factors, (Margolis 1943, inclination of incisors).

(1948) William Downs is credited with developing the first cephalometric analysis. Over the ensuing years multiple cephalometric analysis methods have been established,

  • (1953) Steiner
  • (1954) Tweed
  • (1955) Sassouni
  • (1974) Harvold
  • (1975) Wits
  • (1979) Ricketts
  • (1985) McNamara
  • (1972) Jaraback

Technologies

Initially, cephalometric analysis was performed manually using acetate tracing paper and a lighted view box. Tracings of pertinent diagnostic lines using established orthodontic anatomical landmarks were drawn using a #3 lead pencil. This method of performing an analysis brings in problems of accurate analysis due to human error and differences of experience and expertise of the analyst.

Digital radiographs

(1960s) The proposition of digitalized radiographs as a vehicle for cephalometric analysis came into play and technologies have evolved since that time to make the process faster, easier and more accurate. Types of digital radiographs include:

  • Indirect digital
  • Direct
  • Semi-direct

Computed Tomography (CT) MRI, PET, PET/CT

(1971) First used in the United Kingdom. Technology improvements included reduction in time for the procedure due to increased number of slices produced in the same rotational period and increases in image size. Other imaging modalities followed.

  • (1980) Magnetic Resonance Imaging (MRI)
  • (1985) Positron Emission Tomography (PET)
  • (2000) Positron Emission Tomography/ Computed Tomography (PET/CT)

Initial dental use of CT was necessarily restricted due to the size and expense of the equipment. However, this technology was the basis and cornerstone of today’s use of CBCT in the science of cephalometric analysis.

Cone Beam Computed Tomography (CBCT)

(1995) Tacconi and Mazzo develop a system to utilize CBCT technology for dental purposes.

(2001) CBCT was first introduced in the United States after the “New Tom 9000” machine was approved by the FDA. Using a cone beam rather than a fan beam along with other innovations allowed the equipment for CBCT to be reduced in size enough to be installed in the average dental setting and at a (comparably) affordable price.

(2007) Kodak introduces Ultra CBCT ILUMA scanner

(2007-present) Competition has resulted in different brands of CBCT machines offering their own design, branding advantages, etc. Most often these differences are related to field of view (FOV) and improvements in image resolution.

The increased use of CBCT has resulted in the necessity of a parallel technology improvement in rendering cephalometric analyses. Technology has resulted in computerized software models for in-office and online cephalometric analysis.

Founded in 2001, the online company Cephx has been at the forefront of developments in CBCT cephalometric analysis rendering technology. These developments in technology allow Cephx to provide orthodontists and other dental practitioners with cutting edge solutions regarding analyses, cloud storage and patient records management.

For more information please contact info@cephx.com or 1-800-992-1499

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Orthodontic Adverse Effects – Helping Patients Understand Them

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A discussion of orthodontic adverse effects and the signing of an informed consent document are important steps prior to the initiation of clinical orthodontic treatment procedures.

It has been demonstrated that patients may listen to an outline of possible dental or medical deleterious side effects, not really understand them, respond negatively when asked if they have any questions and then just routinely sign the consent form as a matter of habit.

This type of scenario invites misunderstandings down the orthodontic treatment “road” and experience shows there are usually at least a few bumps along this road for both patient and practitioner.

Clinical explanations of adverse effects may be met with nodding heads, but in many cases patients will have hardly a clue what the implications of say, “termination of treatment due to unexpected root resorption” or “exacerbation of temporo-mandibular joint disorder symptoms” may mean. Better to smooth out the road before traveling down it.

“I remind students that most of them possess the same limited understanding of medical language as many of their future patients, and I encourage them to always remember those feelings of confusion, uncertainty and anxiety.”  Dr. Frank R. Serrecchia, Midwestern University

While practitioners may not use the sterile clinical language as mentioned above when talking about adverse effects of orthodontic treatment or dentistry in general to their patients, making sure the patient has at least a reasonable layman’s understanding may help both parties know that they are “on the same page”. This approach can help mitigate later misunderstandings if treatment or patient expectations come into question.

If there is doubt that informed consent may be misunderstood or only partly understood by a layman, a practitioner need only look at the American Association of Orthodontists informed consent (1) form.  Although an excellent well thought out document, it informs the patient using dental jargon for the most part. Granted, this dental “language” may be required for legal purposes.

Arguably however, it is understandable that a patient might have some difficulties answering an honest  “yes” to the signature acknowledgement, “I hereby acknowledge that I have read and fully understand the treatment considerations and risks presented in this form.”.

As mentioned earlier, patients routinely glance over these types of consent forms and sign them without really knowing the contents. They generally rely and trust what the orthodontist has told them and leave it as that.

Explaining Orthodontic Adverse Effects – Analogies, Metaphors and Similes

A common strategy when attempting to explain complex problems (2)  in meaningful layman’s terms is the use of metaphors, similes and especially, analogies.

  • Analogy: compares things so that a relationship between them can be understood.
  • Simile: compares things by using “like” or “as”, e.g., an implant is like the root of a tooth.
  • Metaphor: compares by saying “is”, e.g., An implant is a “tooth root replacer”.

These methods may be helpful when outlining the nature of orthodontic treatment adverse effects during informed consent discussions.

While each practitioner will have preferences for creating unique analogies (3), similes or metaphors for their own patients and case situations, some examples of possible analogies involving some adverse effects are offered as a starting point.

  • Enamel decalcification – A suggested analogy is a comparison of how household products containing acid may erode, discolor or otherwise damage surfaces. This analogy can be combined with an explanation of how proper oral hygiene practices prevent acid from plaque and food debris from remaining in contact with the enamel around bracket edges, etc., causing “white spots”. Further, that in most cases any damage is usually temporary or can be easily treated micro –abrasion (“sanding”).
  • Periodontal problems – A visual comparison of the attached gingival with a shirt sleeve may help patients understand the progression and damage of periodontal disease from poor oral hygiene practices. A normal attached gingiva equated with a tight sleeve around the wrist, a looser sleeve compared with inflammation and more of the wrist showing – gingival recession.
  • Loss of pupal vitality – A plant may serve as an analogy where the pulp and periapical foramen blood vessels are compared with a plant. Pressure, crushing or cutting of the root (periapical vessels) causes eventual wilting and “death” of the plant.
  • Temporomandibular Disorders (TMD) – Many patients are likely to have suffered a “sore jaw”. However, it might be helpful to relate the Temporomandibular Joint (TMJ) to a door hinge with a spring where repeated opening and closing of the hinge (TMJ) may cause the spring (muscles) to malfunction.
  • Root resorption – Although the exact reasons for root resorption are not understood, a comparison of an icicle shrinking with warmer temperature may be a good visual for a layman’s understanding.
  • Soft tissue damage – Any comparison of a hard object rubbing against a softer object could serve as an appropriate analogy for this adverse effect. One example might be how a carpet is damaged (traumatic ulcer) by excessive foot traffic.
  • Occlusal adjustment – Regarding the need for occlusal equilibration, any analogy that relates sanding an object so that it fits together correctly with another object would be apt.

Another suggestion for appointments that involve informed consent is to have patients repeat back in their own words their “take” on what has been discussed regarding informed consent and adverse effects.

Use of Images

“A picture is worth a thousand words” is certainly true when attempting to explain dental terminology and procedures to laymen patients.  The use of images and/or drawings combined with verbal analogic explanations may increase the chances for understanding by the patient.

If patients are having a difficult time understanding a concept, the use of photos (4), pictures and/or drawing a sketch may often be very helpful.  No art degree is required here. A simple pencil drawing of a tooth root followed by shorter and shorter shrinking tooth root images should suffice to demonstrate root resorption.

A notebook, tablet or computer containing selected photos and/or pictures from the orthodontist’s own practice or internet sources might be worth a small investment in time and a larger later investment not only in patient education, but helping to prevent future patient misinterpretations.

The approach of using analogies, similes and metaphors for helping patients understand  orthodontic adverse effects can be applied to other areas of treatment such as cephalometric analysis, wisdom tooth extraction etc.

Some practitioners may find this analogy, simile and metaphor patient communication method comes naturally to them, while others may find it difficult, cumbersome, seemingly unnecessary or awkward. However, the idea that good communication does enhance patient rapport (5), possible choice of an orthodontist (6) and/or prevent future “difficulties” may be a worthwhile incentive to practice a bit and give these ideas a “dental…….college” try.

References:

(1) http://www.columbia-ortho.com/Informed.pdf

(2) https://www.researchgate.net/profile/Gwinyai_Masukume/publication/221868357_Analogies_and_metaphors_in_clinical_medicine

(3) http://www.dentaleconomics.com/articles/print/volume-89/issue-3/features/clinical-scripts-for-effective-communication.html

(4) http://www.medicinenet.com/script/main/mobileart.asp?articlekey=120284

(5) http://www.jyi.org/issue/trust-in-the-dentist-patient-relationship-a-review/

(6) https://ceph-x.com/hlow-do-patients-choose-their-orthodontist/

Save time and effort analyzing your cephalometric radiographs while helping your patients better understand their own treatment plans by visiting Cephx.

Discover the advantages of online cephalometric analysis in this area of patient care and more at Cephx.

For more information please contact info@cephx.com or 1-800-992-1499

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