Posts filed under ‘Movement Disorders. Functional Orthodontics’

Smile Direct Club – the New Kid on the Block

The launch of this new supplier of “invisible” braces is yet another reminder of how technical advances are rapidly changing the world around us. This international tele-dentistry company was founded in the US five years ago and has rapidly become the largest provider of orthodontic treatment in the US.  Last year, revenue nearly tripled to $423m from about $146m in 2017. According to their website Smile Shops have already opened in twelve locations in the England & Scotland and will be launching in Canada and Australia next year.  So, how does it differ from mainstream orthodontics and what does this mean for the future of orthodontics as we know it?

Smile Direct Club uses 3D scanning and computer technology to create a programme of treatment using clear braces that are posted to the customer.  Only one appointment is required and the treatment is 60% cheaper than the market average.  In the US some orthodontists are so fearful of the threat that Smile Direct Club pose that they have sought unsuccessfully to have tele-dentistry banned.  It is easy to be scathing of treatment that involves less contact with a qualified clinician, but Smile Direct Club appear to have the winning combination of competitive pricing, good results and reliable standards of customer service.

Until now, orthodontics in the UK has been dominated by small clinical practices owned and run by qualified orthodontists who treat a mix of private and NHS patients.  Small clinics already face onerous costs to ensure they meet statutory legislation on employment, care quality and so forth.  Can they survive the downward pressure on prices presented by this direct-to-consumer business model?

Strange as it may seem, this threat may actually be what will spur the speciality, at last, to change tack! Orthodontics at its best is so much more than mere tooth straightening. Early diagnosis and intervention can reduce and even prevent the presentation of crooked teeth.  By treating the face and not just the teeth, orthodontists can offer something that mail order clear braces never can.

The orthodontic profession has the knowledge and practical skills to impact on the health and wellbeing of young children and their future lives.  There are progressive orthodontists like William Clark and John Mew who spent decades pushing the boundaries to develop appliances like the twin block and the biobloc, that have been shown to encourage jaw growth to make room for the adult teeth.  Yet, despite international recognition, they have never been properly recognised for their achievements at home.  Neither one of these men has been invited to speak at a British Orthodontic Society conference.  It is time for the arguments between different factions of the orthodontic profession to end and for collaboration to begin.  If the orthodontic profession wants to survive, it needs to properly understand the causes of malocclusion, its relationship with other conditions like sleep apnoea and TMD and the best ways to prevent and treat it.

In the long run, Smile Direct Club’s quantum leap approach could bring about the changes which so many of the non-establishment practitioners have been calling for decades! Good news for us and better health for patients.


September 30, 2019 at 5:02 pm Leave a comment

How tongue mobility changes face and jaw development.

August 12, 2018 at 11:04 am Leave a comment

Myobrace Introductory Course, 3 March, 2017, 1.00-6.00pm, the Thistle Hyde Park hotel, London.

This 30 minute presentation was an introduction into functional therapy.The aim was to stress the following points:

  1. Nearly all malocclusions have an under-developed upper jaw.
  2. Class II cases have a retrognathic upper and lower jaws.
  3. Children who mouth breathe are running on sub-standard fuel.
  4. 80% of facial growth is complete by the age of 8 so treating in the mixed dentition is the optimal timing.

Treatment aims are to correct bone and muscle imbalance, establish nasal breathing and then align the teeth.

The undergraduate dental programme covers anatomy & physiology in considerable detail.  However, as the course continues the focus is on the oral cavity and the technical side of dentistry. Being able to recognise early signs of imbalance ( mouth breathing, bones, muscle, growth etc.) enables treatment to be initiated before real problems arise. The Myobrace system is designed to address early imbalances with the aim of restoring optimal health in the growing child.

Niels van der Valk continued the session with an overview of the Myobrace system and demonstrated how to recognise incorrect features which may result in the development of malocclusion ie: incorrect swallowing patterns, mouth breathing and poor posture.

For more information refer to the starred links on the Blogroll. Also Airway and TMJ – YouTube.

February 9, 2017 at 4:34 pm Leave a comment

Movement Disorders, Dystonia and Tourettes

I was recently contacted by a lady who had suffered from Dystonia for several years which had severely limited her everyday life. Fortunately she has now made a complete recovery. Her treatment was carried out by Dr André Hedger ( and involved the recognition of Temporo-Mandibular Joint Dysfunction and the misalignment of associated cranial bones. An integrated team approach is required to diagnose and treat these complex cases. Members of the British Society for the Study of Cranio-Mandibular Disorders acknowledge this and a list of other practitioners can be found on the website:

See the Dystonia,TMJ and the connection on Facebook.

October 3, 2016 at 1:26 pm 1 comment

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